MEDICARE: VILLAGE MENTAL HEALTH 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
1	2084P0800X	Psychiatry Physician

General Provider Information

NPI Number	:	1194400309
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VILLAGE MENTAL HEALTH INC

Provider Business Mailing Address
First Line	:	26 COURT ST STE 409
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11242-1134
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	26 COURT ST STE 409
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11242-1134
Country	:	US
Telephone Number	:	708-555-1212
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	DR. KRISTIN GILL
Credential	:	MD
Telephone Number	:	718-736-2821

Provider Enumeration Date	:	06/16/2023
Last Update Date	:	04/13/2026

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Directions to “VILLAGE MENTAL HEALTH INC ” Practice Location

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