MEDICARE: BLANTON-PEALE INSTITUTE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	6673100A	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1225195787
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BLANTON-PEALE INSTITUTE

Provider Business Mailing Address
First Line	:	7 WEST 30TH STREET
Second Line	:	9TH & 10TH FLOOR
City	:	NEW YORK CITY
State	:	NY
Zip	:	10001
Country	:	US
Telephone Number	:	212-725-7850
Fax Number	:	212-967-4919

Provider Business Practice Location Address
First Line	:	7 WEST 30TH STREET
Second Line	:	9TH FLOOR
City	:	NEW YORK CITY
State	:	NY
Zip	:	10001
Country	:	US
Telephone Number	:	212-725-7850
Fax Number	:	212-967-4919

Authorized Official
Title or Position	:	CLINIC DIRECTOR
Name	:	ANN KENNEDY SPRINGER
Credential	:	LCSW
Telephone Number	:	212-725-7850

Provider Enumeration Date	:	01/03/2007
Last Update Date	:	09/03/2019

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Directions to “BLANTON-PEALE INSTITUTE ” Practice Location

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