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General NPI Number Information
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NPI Number | 1679276059
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Entity Type | Organization
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Legal Business Name | MOUNT PLEASANT PSYCHOLOGICAL SERVICES FOR CHILDREN, PLLC
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Dates
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Enumeration Date | 03/23/2023
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Last Update Date | 03/23/2023
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Provider Practice Location Address
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Address Line | 586 COMMERCE ST
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City | THORNWOOD
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State | NY
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Zip | 10594-1355
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Country | US
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Telephone | 914-984-8447
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Fax |
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Provider Business Mailing Address
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Address Line | 586 COMMERCE ST
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City | THORNWOOD
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State | NY
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Zip | 10594-1355
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Country | US
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Telephone | 914-984-8447
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Fax |
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Authorized Official
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Title or Position | LICENSED PSYCHOLOGIST/OWNER
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Name | DR. MADISON ELIZABETH OLSEN
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Credential | PSYD
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Telephone | 914-984-8447
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC2200X
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Taxonomy Name | Clinical Child & Adolescent Psychologist
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License Number |
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License Number State |
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