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General NPI Number Information
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NPI Number | 1982844585
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Entity Type | Organization
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Legal Business Name | PSYCHOLOGICAL MOTIVATION AND CHANGE GROUP OF WESTCHESTER PLLC
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Dates
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Enumeration Date | 02/23/2009
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Last Update Date | 02/23/2009
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Provider Practice Location Address
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Address Line | 235 MAIN ST 5TH FLOOR
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City | WHITE PLAINS
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State | NY
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Zip | 10601-2418
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Country | US
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Telephone | 914-949-0540
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Fax |
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Provider Business Mailing Address
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Address Line | 235 MAIN ST 5TH FLOOR
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City | WHITE PLAINS
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State | NY
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Zip | 10601-2418
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Country | US
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Telephone | 914-949-0540
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Fax |
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Authorized Official
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Title or Position | PARTNER
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Name | CARRIE WILKENS
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Credential | PHD
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Telephone | 212-683-3339
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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 | 0148811
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License Number State | NY
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