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General NPI Number Information
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NPI Number | 1518595727
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Entity Type | Organization
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Legal Business Name | PSYCHIATRIC NURSE PRACTITIONER P.C
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Dates
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Enumeration Date | 04/01/2020
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Last Update Date | 02/06/2026
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Provider Practice Location Address
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Address Line | 245 5TH AVE FL 3
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City | NEW YORK
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State | NY
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Zip | 10016-8728
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Country | US
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Telephone | 718-757-0684
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Fax | 855-344-8343
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Provider Business Mailing Address
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Address Line | 22406 68TH AVE W
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City | MOUNTLAKE TERRACE
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State | WA
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Zip | 98043-2372
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Country | US
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Telephone | 855-444-7258
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Fax | 855-344-8343
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Authorized Official
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Title or Position | OWNER
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Name | DR. HONORINE BETAH
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Credential |
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Telephone | 214-983-9811
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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