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General NPI Number Information
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NPI Number | 1275695371
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Entity Type | Organization
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Legal Business Name | METROPOLITAN CENTER FOR MENTAL HEALTH, INC.
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Dates
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Enumeration Date | 12/14/2006
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Last Update Date | 02/01/2018
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Provider Practice Location Address
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Address Line | 160 W 86TH ST
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City | NEW YORK
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State | NY
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Zip | 10024-4018
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Country | US
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Telephone | 212-362-8755
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Fax | 212-362-9451
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Provider Business Mailing Address
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Address Line | 160 W 86TH ST
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City | NEW YORK
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State | NY
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Zip | 10024-4018
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Country | US
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Telephone | 212-362-8755
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Fax | 212-362-9451
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | DR. ROBERT BASILE
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Credential | PSY.D.
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Telephone | 212-362-8755
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TP2701X
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Taxonomy Name | Group Psychotherapy Psychologist
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License Number | 6722100A
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License Number State | NY
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