| NPI | 1023701067 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANIEL LEE Director 267-259-4558 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| 101YM0800X Counselor, Mental Health | |
| 103TC1900X Psychologist, Counseling | |
| 103TF0000X Psychologist, Family | |
| 103TP0814X Psychologist, Psychoanalysis | |
| 103TP2701X Psychologist, Group Psychotherapy | |
| 1041C0700X Social Worker, Clinical | |
| 2084P0800X Psychiatry & Neurology, Psychiatry | |
| 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry | |
| 2084P0805X Psychiatry & Neurology, Geriatric Psychiatry | |
| 251B00000X Case Management | |
| 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) | |
| 261QM0850X Clinic/Center, Adult Mental Health | |
| 261QM0855X Clinic/Center, Adolescent and Children Mental Health | |
| Enumeration Date | 2023-05-26 |
| Last Update Date | 2023-05-26 |