NPIMap

Organization Active NPI

Mental Health Providers of Western Queens, Inc.

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Woodside, NY
National Provider Identifier
1417314154
Registry record updated Jan 26, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X
License
096826 Issued in NY
Legal business name
MENTAL HEALTH PROVIDERS OF WESTERN QUEENS, INC.
Practice address
6207 Woodside Ave
4TH Floor
Woodside, NY 11377-3576
Phone
(718) 898-5085
Fax
(718) 898-8852
NPI assigned
Jan 26, 2016
Last updated
Jan 26, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 26, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mrs. Cheryl Lazo Montanez, LMSW
Title
Program Director
Phone
(718) 898-5085

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X 096826 NY Primary

Addresses

Primary practice location

6207 Woodside Ave
4TH Floor
Woodside, NY 11377-3576

Mailing address

6207 Woodside Ave
4TH Floor
Woodside, NY 11377-3576
Phone (718) 898-5085

National Provider Directory

National Provider Directory
Tax ID family
Mental Health Providers of Western Queens Inc4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

Locations

6207 Woodside Ave
Ste 4
Woodside, NY 11377
Phone (718) 898-5085

Practitioners & affiliated clinicians

Practitioners 10

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1453766400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1453766400000",
    "number": "1417314154",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6207 WOODSIDE AVE",
            "address_2": "4TH FLOOR",
            "city": "WOODSIDE",
            "state": "NY",
            "postal_code": "113773576",
            "telephone_number": "718-898-5085",
            "fax_number": "718-898-8852"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6207 WOODSIDE AVE",
            "address_2": "4TH FLOOR",
            "city": "WOODSIDE",
            "state": "NY",
            "postal_code": "113773576",
            "telephone_number": "718-898-5085",
            "fax_number": "718-898-8852"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MENTAL HEALTH PROVIDERS OF WESTERN QUEENS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-01-26",
        "last_updated": "2016-01-26",
        "status": "A",
        "authorized_official_last_name": "MONTANEZ",
        "authorized_official_first_name": "CHERYL",
        "authorized_official_middle_name": "LAZO",
        "authorized_official_title_or_position": "PROGRAM DIRECTOR",
        "authorized_official_telephone_number": "718-898-5085",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LMSW"
    },
    "taxonomies": [
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": "NY",
            "license": "096826",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodside, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.