Healthcare Provider Details
I. General information
NPI: 1063126480
Provider Name (Legal Business Name): WESTCHESTER ANXIETY TREATMENT PSYCHOLOGICAL SERVICES, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 01/10/2023
Last Update Date: 01/10/2023
Certification Date: 01/10/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
34 S BROADWAY STE 104
WHITE PLAINS NY
10601-4432
US
IV. Provider business mailing address
34 S BROADWAY STE 104
WHITE PLAINS NY
10601-4432
US
V. Phone/Fax
- Phone: 917-608-5741
- Fax:
- Phone: 917-608-5741
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 103TC0700X |
| Taxonomy | Clinical Psychologist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
JOANNA
ROBIN
Title or Position: DIRECTOR
Credential: PHD
Phone: 917-608-5741