MEDICARE: ATRIUM PSYCHOTHERAPY

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	104100000X	Social Worker

General Provider Information

NPI Number	:	1457043366
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ATRIUM PSYCHOTHERAPY

Provider Business Mailing Address
First Line	:	119 WASHINGTON PL APT C
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10014-3875
Country	:	US
Telephone Number	:	917-331-7543
Fax Number	:

Provider Business Practice Location Address
First Line	:	119 WASHINGTON PL APT C
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10014-3875
Country	:	US
Telephone Number	:	917-331-7543
Fax Number	:

Authorized Official
Title or Position	:	DIRECTOR
Name	:	MELISSA DAUM
Credential	:	LMFT
Telephone Number	:	917-331-7543

Provider Enumeration Date	:	05/22/2023
Last Update Date	:	06/13/2023

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Directions to “ATRIUM PSYCHOTHERAPY ” Practice Location

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