Organization Active NPI

LW NP Psychiatry PC

  • Psychiatric/Mental Health Nurse Practitioner
  • Brooklyn, NY
National Provider Identifier
1417637042
Registry record updated Dec 4, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
Legal business name
LW NP PSYCHIATRY PC
Practice address
142 Joralemon St RM 5
Brooklyn, NY 11201-4747
Phone
(646) 244-3196
NPI assigned
Jul 19, 2023
Last updated
Dec 4, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 4, 2023

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

Authorized official

Name
Lavern Wilson-Dennis
Title
Ceo
Phone
(646) 244-3196

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X NU Primary

Addresses

Primary practice location

142 Joralemon St RM 5
Brooklyn, NY 11201-4747

Mailing address

1057 Eastern Pkwy Apt 2D
Brooklyn, NY 11213-4858

National Provider Directory

National Provider Directory

Locations

142 Joralemon St
Rm 5
Brooklyn, NY 11201
Phone (646) 244-3196

Practitioners & affiliated clinicians

Practitioners 1

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": "1689724800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1701648000000",
    "number": "1417637042",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1057 EASTERN PKWY APT 2D",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112134858"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "142 JORALEMON ST RM 5",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112014747",
            "telephone_number": "646-244-3196"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LW NP PSYCHIATRY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-07-19",
        "last_updated": "2023-12-04",
        "certification_date": "2023-12-04",
        "status": "A",
        "authorized_official_last_name": "WILSON-DENNIS",
        "authorized_official_first_name": "LAVERN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "646-244-3196"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2023; 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.