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General NPI Number Information
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NPI Number | 1316557606
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Entity Type | Organization
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Legal Business Name | CALM MIND PSYCHIATRIC NP SERVICES OF THE FINGER LAKES PLLC
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Dates
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Enumeration Date | 08/03/2020
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Last Update Date | 09/23/2021
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Provider Practice Location Address
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Address Line | 5776 HOWELL RD
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City | LOCKE
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State | NY
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Zip | 13092-3351
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Country | US
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Telephone | 607-423-9304
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Fax | 949-577-4133
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Provider Business Mailing Address
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Address Line | 5776 HOWELL RD
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City | LOCKE
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State | NY
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Zip | 13092-3351
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Country | US
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Telephone | 607-423-9304
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MRS. SHANNON DRAKE
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Credential | NP
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Telephone | 607-423-9304
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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