NPIMap

Organization Active NPI

Samaritan Village Harlem Outpatient

  • Adult Mental Health Clinic/Center
  • New York, NY
National Provider Identifier
1740650332
Registry record updated Sep 25, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X
License
31027 Issued in NY
Legal business name
SAMARITAN VILLAGE HARLEM OUTPATIENT
Practice address
55 W 125TH St
11TH Floor
New York, NY 10027-4516
Phone
(212) 864-4128
Fax
(212) 662-9193
NPI assigned
Sep 25, 2015
Last updated
Sep 25, 2015By the provider in NPPES
Organization subpart
Yes
Parent organization
SAMARITAN VILLAGE, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 25, 2015

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

Authorized official

Name
Sharon Johnson, CASACNPI 1063656551
Title
Caseworker
Phone
(212) 864-4128

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 31027 NY Primary

Addresses

Primary practice location

55 W 125TH St
11TH Floor
New York, NY 10027-4516

Mailing address

55 W 125TH St
11TH Floor
New York, NY 10027-4516
Phone (212) 864-4128

National Provider Directory

National Provider Directory
Tax ID family
Samaritan Village Harlem Outpatient21 organizations share this tax ID, including this one
Part of
Samaritan Village Harlem Outpatient

Other organizations with this tax ID 20

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

View all 20

Locations

55 W 125th St
Fl 11
New York, NY 10027
Phone (212) 864-4128

Practitioners & affiliated clinicians

Practitioners 22

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.

View all 22

NPI Registry JSON

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

{
    "created_epoch": "1443139200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1443139200000",
    "number": "1740650332",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 W 125TH ST",
            "address_2": "11TH FLOOR",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100274516",
            "telephone_number": "212-864-4128",
            "fax_number": "212-662-9193"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 W 125TH ST",
            "address_2": "11TH FLOOR",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100274516",
            "telephone_number": "212-864-4128",
            "fax_number": "212-662-9193"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAMARITAN VILLAGE HARLEM OUTPATIENT",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SAMARITAN VILLAGE, INC.",
        "enumeration_date": "2015-09-25",
        "last_updated": "2015-09-25",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "SHARON",
        "authorized_official_title_or_position": "CASEWORKER",
        "authorized_official_telephone_number": "212-864-4128",
        "authorized_official_credential": "CASAC"
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": "NY",
            "license": "31027",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2015; 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.