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NPI Code Detail

MEDICARE: SUS MENTAL HEALTH PROGRAMS, INC.

MEDICARE: SUS MENTAL HEALTH PROGRAMS, INC.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health Counselor
2251S00000XCommunity/Behavioral Health Agency

General Provider Information

NPI Number : 1053696195
Entity Type Code : Organization
Provider Name (Legal Business Name) : SUS MENTAL HEALTH PROGRAMS, INC.
Provider Business Mailing Address
First Line : 463 FASHION AVE FL 17
Second Line :
City : NEW YORK
State : NY
Zip : 10018-0092
Country : US
Telephone Number : 646-629-7363
Fax Number : 855-370-9384
Provider Business Practice Location Address
First Line : 1125 FULTON ST
Second Line :
City : BROOKLYN
State : NY
Zip : 11238-2669
Country : US
Telephone Number : 347-226-9025
Fax Number :
Authorized Official
Title or Position : VP REVENUE CYCLE
Name : MS. OKSANA MARANTS
Credential :
Telephone Number : 646-629-7363
Provider Enumeration Date : 10/20/2011
Last Update Date : 06/02/2026

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