NPIMap

Organization Active NPI

Wise Mind Psychological Services P.L.L.C.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Wantagh, NY
National Provider Identifier
1598237158
Registry record updated Dec 20, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Legal business name
WISE MIND PSYCHOLOGICAL SERVICES P.L.L.C.
Practice address
3330 Park Ave
Wantagh, NY 11793-3719
Phone
(516) 740-1950
NPI assigned
Dec 20, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 20, 2018

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

Authorized official

Name
Dr. Rachel M. Bowley, PSY.D.NPI 1720337116
Title
Clinical Director
Phone
(516) 250-0980

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X Primary

Addresses

Primary practice location

3330 Park Ave
Wantagh, NY 11793-3719

Mailing address

1800 Gormley Ave
Merrick, NY 11566-3009
Phone (516) 250-0980

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190403002177 NY Part B Supplier - Clinic/Group Practice 1254672025 Receives reassigned benefits from 7 practitioners
Practice locations: Garden City, NY; Rockville Centre, NY

National Provider Directory

National Provider Directory

Locations

401 Franklin Ave
Ste 310
Garden City, NY 11530
Phone (516) 740-1950

77 N Centre Ave
Ste 310
Rockville Ctr, NY 11570
Phone (516) 740-1590

3330 Park Ave
Ste 9
Wantagh, NY 11793
Phone (347) 741-9301

Practitioners & affiliated clinicians

Practitioners 16

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

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1545264000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1545264000000",
    "number": "1598237158",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1800 GORMLEY AVE",
            "city": "MERRICK",
            "state": "NY",
            "postal_code": "115663009",
            "telephone_number": "516-250-0980"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3330 PARK AVE",
            "city": "WANTAGH",
            "state": "NY",
            "postal_code": "117933719",
            "telephone_number": "516-740-1950"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WISE MIND PSYCHOLOGICAL SERVICES P.L.L.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-12-20",
        "last_updated": "2018-12-20",
        "status": "A",
        "authorized_official_last_name": "BOWLEY",
        "authorized_official_first_name": "RACHEL",
        "authorized_official_middle_name": "M.",
        "authorized_official_title_or_position": "CLINICAL DIRECTOR",
        "authorized_official_telephone_number": "516-250-0980",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSY.D."
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wantagh, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.