Staten Island Mental Health Society, Inc.

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

License

6567100A Issued in NY

Legal business name

STATEN ISLAND MENTAL HEALTH SOCIETY, INC.

Practice address

669 Castleton Ave
Staten Island, NY 10301-2028

Phone

(718) 442-2225

NPI assigned

Feb 28, 2007

Organization subpart

No

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

Authorized official

Name

Ms. Fern Zagor, LCSW, ACSWNPI 1407071905

Title

Executive VP-Coo

Phone

(718) 442-2225

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 1

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

• Fern Aaron Zagor, L.C.S.W.

  • Clinical Social Worker
  • Staten Island, NY
  • NPI 1407071905
  NPD (past) Authorized official

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

{
    "created_epoch": "1172620800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1841328358",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "669 CASTLETON AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103012028",
            "telephone_number": "718-442-2225"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "669 CASTLETON AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103012028",
            "telephone_number": "718-442-2225"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STATEN ISLAND MENTAL HEALTH SOCIETY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-28",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "ZAGOR",
        "authorized_official_first_name": "FERN",
        "authorized_official_title_or_position": "EXECUTIVE VP-COO",
        "authorized_official_telephone_number": "718-442-2225",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "LCSW, ACSW"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NY",
            "license": "6567100A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00244344",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Staten Island Medicine PC
• Staten Island Mental Health Counseling PLLC
• Staten Island Mental Health Society
• Staten Island Mental Health Society
• Staten Island Mental Health Society
• Staten Island Neonatology PC
• Staten Island Nephrology PC
• Staten Island Ophthalmology, PC
• Staten Island Oral & Maxillofacial Surgery
• Staten Island Orthopedics & Sports Medicine P.C

• Community/Behavioral Health Agency in Staten Island, NY
• Providers in Staten Island, NY by specialty
• Community/Behavioral Health Agency in New York

• 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.