NPIMap

Organization Active NPI

Park Ave Psychotherapy

  • Social Worker
  • Rockaway Park, NY
National Provider Identifier
1619226966
Registry record updated Aug 31, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
R027402 Issued in NY
Legal business name
PARK AVE PSYCHOTHERAPY
Practice address
167 Beach 135TH St.
Rockaway Park, NY 11694-1303
Phone
(718) 634-0253
Fax
(718) 634-1056
NPI assigned
Aug 31, 2012
Last updated
Aug 31, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 31, 2012

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

Authorized official

Name
Ms. Andrea Rhonda GitterNPI 1457537292
Title
Director
Phone
(718) 634-0253

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Child & Adolescent Psychologist 103TC2200X R027402 NY
Social Worker 104100000X R027402 NY Primary
Clinical Social Worker 1041C0700X R027402 NY
Child & Adolescent Psychiatry Physician 2084P0804X R027402 NY
Dance Therapist 225600000X 05000472 NY

Addresses

Primary practice location

167 Beach 135TH St.
Rockaway Park, NY 11694-1303

Mailing address

167 Beach 135TH St.
Rockaway Park, NY 11694-1303
Phone (718) 634-0253

National Provider Directory

National Provider Directory
Tax ID family
Ny Group for Psychotherapies2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the 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, 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": "1346371200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1346371200000",
    "number": "1619226966",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "167 BEACH 135TH ST.",
            "city": "ROCKAWAY PARK",
            "state": "NY",
            "postal_code": "116941303",
            "telephone_number": "718-634-0253",
            "fax_number": "718-634-1056"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "167 BEACH 135TH ST.",
            "city": "ROCKAWAY PARK",
            "state": "NY",
            "postal_code": "116941303",
            "telephone_number": "718-634-0253",
            "fax_number": "718-634-1056"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PARK AVE PSYCHOTHERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-08-31",
        "last_updated": "2012-08-31",
        "status": "A",
        "authorized_official_last_name": "GITTER",
        "authorized_official_first_name": "ANDREA",
        "authorized_official_middle_name": "RHONDA",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "718-634-0253",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "NY",
            "license": "R027402",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "R027402",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "R027402",
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "NY",
            "license": "R027402",
            "primary": false
        },
        {
            "code": "225600000X",
            "taxonomy_group": "",
            "desc": "Dance Therapist",
            "state": "NY",
            "license": "05000472",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockaway Park, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2012; 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.