MARY MITCHELL HADDAD PMHNP LLC (NPI# 1104325695) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104325695 |
| Entity Type | Organization |
| Organization Name | MARY MITCHELL HADDAD PMHNP LLC |
| Practice Address |
211 E 43rd St Rm 1305 New York NY 10017-4779 |
| Mailing Address |
960 Green Cir Orange CT 06477-1736 |
| Practice Telephone | 2039527571 |
| Practice Fax Number | 2126425111 |
| Mailing Telephone | 2039527571 |
| Enumeration Date | 2018-02-09 |
| Last Update Date | 2018-03-17 |
| Authorized Official Name | MS. MARY MITCHELL HADDAD (PMHNP) |
| Authorized Official Telephone | 2039527571 |
| Authorized Official Credential | RN, MSN, PMHNP |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM0850X |
Clinic/Center Specialization: Adult Mental Health |
F402319-1 | NY | Ambulatory Health Care Facilities |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 211 E 43rd St, New York, NY 100174707 | 2039527571 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| New York State Corporations | MARY MITCHELL HADDAD PMHNP LLC | 211 East 43rd St, Ste 1305, New York, Ny 10017 |
| Street Address |
211 E 43RD ST RM 1305 |
| City | NEW YORK |
| State | NY |
| Zip Code | 10017-4779 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326569120 | Mary Ellen Mitchell Haddad | Registered Nurse | 211 E 43rd St Rm 1305, New York, NY 10017-4779 | 2017-06-30 |
| 1093291767 | Crystal Renee Hartley-lee | Social Worker | 211 E 43rd St Rm 1305, New York, NY 10017-4779 | 2018-07-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700424702 | Amanda Arielle Grannum | Social Worker | 227 E 41st Street, New York, NY 10017 | 2019-12-20 |
| 1205399748 | Jasmine Marie Williams | Social Worker | Comprehensive Therapeutic Services, 450 Lexington Ave, Fourth Floor, New York, NY 10017 | 2019-04-11 |
| 1093208415 | Kaylin Salubro | Nurse Practitioner | 18 E 41st St Fl 12, New York, NY 10017 | 2018-06-11 |
| 1932698792 | Bryan Cordes | Social Worker | 295 Madison Avenue, Suite 707, New York, NY 10017 | 2018-05-08 |
| 1376048173 | Matthew Bernstein, M.d. Pllc | Psychiatry & Neurology | 370 Lexington Avenue, Suite 1001, New York, NY 10017 | 2018-03-26 |
| 1285137430 | Midtown East Podiatry and Foot Surgery L.L.C. | Podiatrist | 230 E 48th St., #1b, New York, NY 10017 | 2018-03-14 |
| 1831692136 | Olga S Pankiv | Nurse Practitioner | 545 5th Avenue Suite 817, 545 5th Avenue Suite 817, New York, NY 10017 | 2018-03-13 |
| 1023523198 | Randa Jaafar Md,pc | Pain Medicine | 340 East 49th St., Ground Floor, New York, NY 10017 | 2017-12-11 |
| 1962912154 | Yonatan Moshe Sobin | Psychologist | 370 Lexington Ave Rm 1000, New York, NY 10017 | 2017-10-03 |
| 1558880344 | Jendayi Polite | Counselor | 100 Park Ave Fl 16, New York, NY 10017 | 2017-09-13 |
| Find all providers in zip 10017 | ||||
| Taxonomy Code | 261QM0850X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Adult Mental Health |
| An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in adults. |
| Notes: [7/1/2003: new] |
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| 1548802770 | Christopher Bandini, Inc | Clinic/Center | 303 5th Ave Rm 1703, New York, NY 10016-6641 | 2019-10-09 |
| 1407418379 | Housing Works Services, Inc. | Clinic/Center | 743- East 9th Street, Omh Department, New York, NY 10009 | 2019-07-01 |
| 1184196644 | Gab Brands, LLC | Clinic/Center | 505 W 54th St Apt 713, New York, NY 10019-5059 | 2018-12-21 |
| 1164994786 | Frameworks Counseling Lcsw P.C. | Clinic/Center | 125 E 23rd St Fl 5, New York, NY 10010-4581 | 2018-12-20 |
| 1265931984 | Nyc Therapeutic Wellness | Clinic/Center | 303 5th Ave Rm 606, New York, NY 10016-6685 | 2018-02-08 |
| 1447707146 | Gary M Prottas, Lcsw Psychotherapist Pllc | Clinic/Center | 20 West 20th Street, Room 239, New York, NY 10011-4313 | 2016-09-09 |
| 1881043370 | Margaret M. Rombone, Ph.d. | Clinic/Center | 51 E 25th St Ste 7h, New York, NY 10010-8209 | 2016-06-06 |
| 1003270224 | Peter Reznik | Clinic/Center | 1641 3rd Ave Ste 201, New York, NY 10128-3623 | 2016-04-13 |
| 1417313024 | Jerome Boling | Clinic/Center | 2090 7th Ave Fl 4, New York, NY 10027-4941 | 2016-01-12 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.