Provider Demographics
NPI:1861550030
Name:PSYCHOTHERAPY ASSOCIATES OF WESTCHESTER
Entity type:Organization
Organization Name:PSYCHOTHERAPY ASSOCIATES OF WESTCHESTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:R
Authorized Official - Last Name:STELLMAN
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW-R
Authorized Official - Phone:914-632-4830
Mailing Address - Street 1:4 STANTON CIR
Mailing Address - Street 2:
Mailing Address - City:NEW ROCHELLE
Mailing Address - State:NY
Mailing Address - Zip Code:10804-1217
Mailing Address - Country:US
Mailing Address - Phone:914-632-4830
Mailing Address - Fax:914-633-5406
Practice Address - Street 1:4 STANTON CIR
Practice Address - Street 2:
Practice Address - City:NEW ROCHELLE
Practice Address - State:NY
Practice Address - Zip Code:10804-1217
Practice Address - Country:US
Practice Address - Phone:914-632-4830
Practice Address - Fax:914-633-5406
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-04
Last Update Date:2007-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR-0217901041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYN42941Medicare PIN