Brooklyn Healthy Mind 360- Nurse Practitioner in Psychiatry PLLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

BROOKLYN HEALTHY MIND 360- NURSE PRACTITIONER IN PSYCHIATRY PLLC

Practice address

26 Court St Ste 409
Brooklyn, NY 11242-1134

Phone

(347) 450-1294

NPI assigned

Oct 7, 2020

Organization subpart

No

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

Authorized official

Name

Kellie Carey

Title

Credentialing Manager

Phone

(516) 729-8606

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1602028800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1602028800000",
    "number": "1932706413",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26 COURT ST STE 409",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112421134",
            "telephone_number": "347-450-1294"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26 COURT ST STE 409",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112421134",
            "telephone_number": "347-450-1294"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BROOKLYN HEALTHY MIND 360- NURSE PRACTITIONER IN PSYCHIATRY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-10-07",
        "last_updated": "2020-10-07",
        "certification_date": "2020-10-07",
        "status": "A",
        "authorized_official_last_name": "CAREY",
        "authorized_official_first_name": "KELLIE",
        "authorized_official_title_or_position": "CREDENTIALING MANAGER",
        "authorized_official_telephone_number": "516-729-8606"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Social Worker in Brooklyn, NY
• Providers in Brooklyn, NY by specialty
• Clinical Social Worker in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 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.