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General NPI Number Information
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NPI Number | 1417133836
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Entity Type | Organization
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Legal Business Name | POSTGRADUATE CENTER FOR MENTAL HEALTH
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Dates
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Enumeration Date | 01/16/2008
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Last Update Date | 01/16/2008
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Provider Practice Location Address
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Address Line | 344 W. 36TH STREET P.G.C.M.H.
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City | NEW YORK
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State | NY
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Zip | 10018-3850
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Country | US
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Telephone | 212-560-6774
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Fax |
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Provider Business Mailing Address
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Address Line | 344 W. 36TH ST P.G.C.M.H.
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City | NEW YORK
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State | NY
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Zip | 10018-3850
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Country | US
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Telephone | 212-560-6774
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Fax |
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Authorized Official
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Title or Position | COORDINATOR OF CDT
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Name | MS. BONNIE MILLER LADDS
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Credential | LCSW
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Telephone | 212-560-6774
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | R037062
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License Number State | NY
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