SLM Nurse Practitioner in Psychiatry PLLC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

Legal business name

SLM NURSE PRACTITIONER IN PSYCHIATRY PLLC

Practice address

900 Ave at Port Imperial Blvd Apt 441
Weehawken, NJ 07086-6103

Phone

(646) 907-3581

NPI assigned

May 24, 2023

Organization subpart

No

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

Authorized official

Name

Ms. Seria Mullen, NPNPI 1578210563

Title

Ceo

Phone

(646) 907-3581

Specialties & licenses 1

Addresses

Other names 1

• Metta Psychiatry Doing business as

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.

• Seria Mullen, NP

  • Psychiatric/Mental Health Nurse Practitioner
  • New York, NY
  • NPI 1578210563
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1684886400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1684886400000",
    "number": "1750073037",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 AVE AT PORT IMPERIAL BLVD APT 441",
            "city": "WEEHAWKEN",
            "state": "NJ",
            "postal_code": "070866103",
            "telephone_number": "646-907-3581"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 AVE AT PORT IMPERIAL BLVD APT 441",
            "city": "WEEHAWKEN",
            "state": "NJ",
            "postal_code": "070866103",
            "telephone_number": "646-907-3581"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SLM NURSE PRACTITIONER IN PSYCHIATRY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-05-24",
        "last_updated": "2023-05-24",
        "certification_date": "2023-05-24",
        "status": "A",
        "authorized_official_last_name": "MULLEN",
        "authorized_official_first_name": "SERIA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "646-907-3581",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "NP"
    },
    "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": [
        {
            "organization_name": "Metta Psychiatry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Psychiatric/Mental Health Nurse Practitioner in Weehawken, NJ
• Providers in Weehawken, NJ by specialty
• Psychiatric/Mental Health Nurse Practitioner in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2023; 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.