Organization Active NPI

Whole Mind Psychology, PLLC

  • Clinical Child & Adolescent Psychologist
  • New York, NY
National Provider Identifier
1497485650
Registry record updated Jun 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Child & Adolescent PsychologistTaxonomy code 103TC2200X
Legal business name
WHOLE MIND PSYCHOLOGY, PLLC
Practice address
330 W 58TH St Ste 604
New York, NY 10019-1817
Phone
(646) 450-3455
NPI assigned
Jun 12, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 12, 2022

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

Authorized official

Name
Dr. Rachel Lynn Shelley, PH.D.NPI 1588281851
Title
Founder
Phone
(646) 450-3455

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Cognitive & Behavioral PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TB0200X
Clinical Child & Adolescent PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TC2200X Primary
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X

Addresses

Primary practice location

330 W 58TH St Ste 604
New York, NY 10019-1817

Mailing address

330 W 58TH St Ste 604
New York, NY 10019-1817
Phone (646) 450-3455

National Provider Directory

National Provider Directory

Locations

330 W 58th St
Ste 604
New York, NY 10019
Phone (646) 450-3455

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1654992000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1654992000000",
    "number": "1497485650",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "330 W 58TH ST STE 604",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100191817",
            "telephone_number": "646-450-3455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "330 W 58TH ST STE 604",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100191817",
            "telephone_number": "646-450-3455"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WHOLE MIND PSYCHOLOGY, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-06-12",
        "last_updated": "2022-06-12",
        "certification_date": "2022-06-12",
        "status": "A",
        "authorized_official_last_name": "SHELLEY",
        "authorized_official_first_name": "RACHEL",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "FOUNDER",
        "authorized_official_telephone_number": "646-450-3455",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103TB0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Cognitive & Behavioral",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2022; 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.