Putting It Together @ Sharlene Willock NP in Psychiatry PLLC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

Legal business name

PUTTING IT TOGETHER @ SHARLENE WILLOCK NP IN PSYCHIATRY PLLC

Practice address

165 N Village Ave Ste 12
Rockville Centre, NY 11570-3701

Phone

(516) 350-8564

Fax

(516) 874-2477

NPI assigned

Jul 10, 2024

Organization subpart

No

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

Authorized official

Name

Sharlene Willock, PMHNPNPI 1659512051

Title

Owner

Phone

(516) 350-8564

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Practitioners 1

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

• Sharlene Willock, FNP, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Fresh Meadows, NY
  • NPI 1659512051
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1720569600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1720569600000",
    "number": "1700623543",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "165 N VILLAGE AVE STE 12",
            "city": "ROCKVILLE CENTRE",
            "state": "NY",
            "postal_code": "115703701",
            "telephone_number": "516-350-8564",
            "fax_number": "516-874-2477"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "165 N VILLAGE AVE STE 12",
            "city": "ROCKVILLE CENTRE",
            "state": "NY",
            "postal_code": "115703701",
            "telephone_number": "516-350-8564",
            "fax_number": "516-874-2477"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PUTTING IT TOGETHER @ SHARLENE WILLOCK NP IN PSYCHIATRY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-07-10",
        "last_updated": "2024-07-10",
        "certification_date": "2024-07-10",
        "status": "A",
        "authorized_official_last_name": "WILLOCK",
        "authorized_official_first_name": "SHARLENE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "516-350-8564",
        "authorized_official_credential": "PMHNP"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Psychiatric/Mental Health Nurse Practitioner in Rockville Centre, NY
• Providers in Rockville Centre, NY by specialty
• Psychiatric/Mental Health Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2024; 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.