Individual provider Active NPI

Vivette Fletcher-Harriott

  • Psychiatric/Mental Health Nurse Practitioner
  • Springfield Gardens, NY
National Provider Identifier
1710335369
Registry record updated May 24, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
F401990-1 Issued in NY
Practice address
14454 177TH Street
Springfield Gardens, NY 11434
Phone
(917) 450-5600
NPI assigned
May 24, 2016
Last updated
May 24, 2016By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 24, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X F401990-1 NY Primary

Addresses

Primary practice location

14454 177TH Street
Springfield Gardens, NY 11434

Mailing address

14454 177TH Street
Springfield Gardens, NY 11434
Phone (917) 450-5600

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170215002191 NY Practitioner - Nurse Practitioner 1153604228 Reassigns benefits to 3 organizations
Practice locations: Jamaica, NY

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
F401990-1NYMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Ra Psychiatric NP Services PLLC CurrentSince Oct 22, 2021 Accepting new patients
Damian Family Care Centers, Inc. CurrentSince Mar 1, 2020 Accepting new patients
Damian Family Care Centers, Inc. CurrentSince Mar 1, 2020 Accepting new patients
New York Psychotherapy and Counseling Center CurrentSince Dec 13, 2016 Accepting new patients
Coordinated Behavioral Care Ipa Inc Past Accepting new patients

Locations

548 Throggs Neck Expy
Bronx, NY 10465
Phone (800) 632-7969

102 Pilling St
Brooklyn, NY 11207
Phone (718) 602-1000

2857 Linden Blvd
Brooklyn, NY 11208
Phone (718) 235-3100

17620 148th Ave
Jamaica, NY 11434
Phone (718) 553-1100

8956 162nd St
#3
Jamaica, NY 11432
Phone (718) 297-8000

340 Trinity St
Malverne, NY 11565
Phone (347) 627-6100

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1464048000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1464048000000",
    "number": "1710335369",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14454 177TH STREET",
            "city": "SPRINGFIELD GARDENS",
            "state": "NY",
            "postal_code": "11434",
            "telephone_number": "917-450-5600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14454 177TH STREET",
            "city": "SPRINGFIELD GARDENS",
            "state": "NY",
            "postal_code": "11434",
            "telephone_number": "917-450-5600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FLETCHER-HARRIOTT",
        "first_name": "VIVETTE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-05-24",
        "last_updated": "2016-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NY",
            "license": "F401990-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield Gardens, NY

Sources for this page

Verify at the official NPI Registry.