NPIMap

Organization Active NPI

Private Mental Health Group LLC

  • Adult Mental Health Clinic/Center
  • Fort Lauderdale, FL
National Provider Identifier
1639865678
Registry record updated Apr 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X
Legal business name
PRIVATE MENTAL HEALTH GROUP LLC
Practice address
12 SE 7TH Street
Suite 705
Fort Lauderdale, FL 33301
Phone
(954) 794-9000
Fax
(754) 800-2610
NPI assigned
Apr 13, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 13, 2023

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

Authorized official

Name
Dr. Olga Katz, M.D.NPI 1992858096
Title
Medical Director
Phone
(917) 494-4975

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Mental Health Clinic/Center 261QM0850X Primary
Adolescent and Children Mental Health Clinic/Center 261QM0855X

Addresses

Primary practice location

12 SE 7TH Street
Suite 705
Fort Lauderdale, FL 33301

Mailing address

3100 North Ocean Blvd
Unit 603
Fort Lauderdale, FL 33308
Phone (646) 512-3203

National Provider Directory

National Provider Directory
Tax ID family
Private Mental Health Group LLC2 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": "1681344000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1681344000000",
    "number": "1639865678",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3100 NORTH OCEAN BLVD",
            "address_2": "UNIT 603",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "33308",
            "telephone_number": "646-512-3203",
            "fax_number": "754-800-2610"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12 SE 7TH STREET",
            "address_2": "SUITE 705",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "33301",
            "telephone_number": "954-794-9000",
            "fax_number": "754-800-2610"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIVATE MENTAL HEALTH GROUP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-04-13",
        "last_updated": "2023-04-13",
        "certification_date": "2023-04-13",
        "status": "A",
        "authorized_official_last_name": "KATZ",
        "authorized_official_first_name": "OLGA",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "917-494-4975",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Lauderdale, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 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.