Healthcare Provider Details

I. General information

NPI: 1114780616
Provider Name (Legal Business Name): HELLO PSYCHIATRY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/06/2024
Last Update Date: 04/02/2024
Certification Date: 04/02/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2 UNIVERSITY PLZ
HACKENSACK NJ
07601-6202
US

IV. Provider business mailing address

6143 SPRINGFIELD BLVD UNIT 640221
BAYSIDE NY
11364-3480
US

V. Phone/Fax

Practice location:
  • Phone: 347-753-8833
  • Fax:
Mailing address:
  • Phone: 347-753-8833
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: LA RISA GRAHAM
Title or Position: DIRECTOR
Credential:
Phone: 347-753-8833