Healthcare Provider Details

I. General information

NPI: 1174292866
Provider Name (Legal Business Name): HEADWAY CALIFORNIA BEHAVIORAL HEALTH SERVICES, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/07/2021
Last Update Date: 09/29/2025
Certification Date: 09/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

205 HUDSON ST FL 9
NEW YORK NY
10013-1810
US

IV. Provider business mailing address

205 HUDSON ST FL 9
NEW YORK NY
10013-1810
US

V. Phone/Fax

Practice location:
  • Phone: 646-453-6777
  • Fax: 212-337-9841
Mailing address:
  • Phone: 646-453-6777
  • Fax: 929-596-7897

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State

VIII. Authorized Official

Name: CARY CRALL
Title or Position: MEDICAL DIRECTOR
Credential:
Phone: 646-453-6777