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General NPI Number Information
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NPI Number | 1558801977
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Entity Type | Organization
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Legal Business Name | MINDWELL PSYCHOLOGY NYC PLLC
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Dates
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Enumeration Date | 03/04/2017
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Last Update Date | 04/27/2018
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Provider Practice Location Address
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Address Line | 80 8TH AVE SUITE 711
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City | NEW YORK
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State | NY
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Zip | 10011-5126
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Country | US
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Telephone | 646-809-5440
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Fax |
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Provider Business Mailing Address
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Address Line | 80 8TH AVE SUITE 711
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City | NEW YORK
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State | NY
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Zip | 10011-5126
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Country | US
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Telephone | 646-809-5440
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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. REBECCA SKOLNICK
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Credential | PH.D.
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Telephone | 646-809-5440
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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 | 021280
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 018408
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License Number State | NY
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Taxonomy #3
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | P09302
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License Number State | NY
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Taxonomy #4
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 021210
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License Number State | NY
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Taxonomy #5
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 020696
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License Number State | NY
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