Healthcare Provider Details

I. General information

NPI: 1861149445
Provider Name (Legal Business Name): UJIMA PSYCHOLOGICAL SERVICES PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/03/2022
Last Update Date: 03/03/2022
Certification Date: 03/03/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

116 W 23RD ST STE 500
NEW YORK NY
10011-2599
US

IV. Provider business mailing address

75 S BROADWAY FL 4
WHITE PLAINS NY
10601-4413
US

V. Phone/Fax

Practice location:
  • Phone: 347-620-6683
  • Fax:
Mailing address:
  • Phone: 347-620-6683
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: DR. JONATHAN MCCLAIN
Title or Position: OWNER
Credential: PHD
Phone: 347-620-6683