NPIMap

Organization Active NPI

Riverdale Mental Health Clinic-Mica PGRM

  • Adult Mental Health Clinic/Center
  • Bronx, NY
National Provider Identifier
1649299694
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X
License
6733100A Issued in NY
Legal business name
RIVERDALE MENTAL HEALTH CLINIC-MICA PGRM
Practice address
5676 Riverdale Ave
Suite 202
Bronx, NY 10471-2138
Phone
(718) 796-5300
NPI assigned
Jul 19, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Robert Brewster, LCSWNPI 1366471476
Title
Executive Director
Phone
(718) 796-5300

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Mental Health Clinic/Center 261QM0850X 6733100A NY Primary

Addresses

Primary practice location

5676 Riverdale Ave
Suite 202
Bronx, NY 10471-2138

Mailing address

5676 Riverdale Ave
Suite 202
Bronx, NY 10471-2138
Phone (718) 796-5300

National Provider Directory

National Provider Directory
Tax ID family
Riverdale Mental Health Association Inc7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

Organizations that report the same tax identification number in the National Provider Directory.

Locations

5676 Riverdale Ave
Ste 202
Bronx, NY 10471
Phone 7187965300104

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": "1153267200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1649299694",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5676 RIVERDALE AVE",
            "address_2": "SUITE 202",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104712138",
            "telephone_number": "718-796-5300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5676 RIVERDALE AVE",
            "address_2": "SUITE 202",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104712138",
            "telephone_number": "718-796-5300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RIVERDALE MENTAL HEALTH CLINIC-MICA PGRM",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-19",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BREWSTER",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "718-796-5300",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": "NY",
            "license": "6733100A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.