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General NPI Number Information
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NPI Number | 1528758547
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Entity Type | Organization
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Legal Business Name | NEW HEIGHTS PSYCHOLOGICAL SERVICES, PLLC
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Dates
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Enumeration Date | 05/11/2023
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Last Update Date | 05/11/2023
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Provider Practice Location Address
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Address Line | 15 RIVERSIDE LN
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City | STATEN ISLAND
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State | NY
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Zip | 10302-1106
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Country | US
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Telephone | 347-210-1834
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Fax |
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Provider Business Mailing Address
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Address Line | 99 WALL ST # 1461
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City | NEW YORK
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State | NY
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Zip | 10005-4301
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Country | US
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Telephone | 646-236-8911
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Fax |
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Authorized Official
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Title or Position | LICENSED CLINICAL PSYCHOLOGIST
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Name | DR. GRACE FEYIJINMI
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Credential |
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Telephone | 347-210-1834
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number |
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License Number State |
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