Organization Active NPI

Lena Addo, Incorporated

  • Clinical Psychologist
  • Brooklyn, NY
National Provider Identifier
1609058809
Registry record updated Nov 29, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
013403 Issued in NY
Legal business name
LENA ADDO, INCORPORATED
Practice address
621 Gates Avenue
Brooklyn, NY 11221-1243
Phone
(917) 755-6976
NPI assigned
Nov 29, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 29, 2007

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

Authorized official

Name
Lena Addo, PH.DNPI 1275729337
Title
Executive Director
Phone
(917) 755-6976

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
Clinical PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TC0700X 013403 NY Primary

Addresses

Primary practice location

621 Gates Avenue
Brooklyn, NY 11221-1243

Mailing address

621 Gates Aveune
Brooklyn, NY 11221-1243
Phone (917) 755-6976

Other identifiers 1

IdentifierTypeStateIssuer
02064340MedicaidNY

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1196294400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1196294400000",
    "number": "1609058809",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "621 GATES AVEUNE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112211243",
            "telephone_number": "917-755-6976"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "621 GATES AVENUE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112211243",
            "telephone_number": "917-755-6976"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LENA ADDO, INCORPORATED",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-29",
        "last_updated": "2007-11-29",
        "status": "A",
        "authorized_official_last_name": "ADDO",
        "authorized_official_first_name": "LENA",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "917-755-6976",
        "authorized_official_credential": "PH.D"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "013403",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02064340",
            "state": "NY"
        }
    ],
    "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 Nov 29, 2007; 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.