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General NPI Number Information
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NPI Number | 1154528867
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Entity Type | Organization
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Legal Business Name | PRIMECARE BEHAVIORAL HEALTH
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Dates
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Enumeration Date | 06/27/2007
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 297 KNOLLWOOD RD
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City | WHITE PLAINS
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State | NY
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Zip | 10607-1833
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Country | US
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Telephone | 914-686-6891
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Fax | 914-682-7518
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Provider Business Mailing Address
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Address Line | 297 KNOLLWOOD RD
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City | WHITE PLAINS
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State | NY
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Zip | 10607-1833
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Country | US
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Telephone | 914-686-6891
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Fax | 914-682-7518
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Authorized Official
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Title or Position | CLINICAL DIRECTOR
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Name | DR. GRANT MITCHELL
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Credential | M.D.
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Telephone | 914-686-6891
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 013089-1
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 014915-1
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License Number State | NY
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Taxonomy #3
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | R022413-1
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License Number State | NY
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