MINDHEALTH PSYCHOLOGICAL SERVICES, PLLC (NPI# 1205239480) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1205239480 |
| Entity Type | Organization |
| Organization Name | MINDHEALTH PSYCHOLOGICAL SERVICES, PLLC |
| Practice Address |
3669 Main St Suite 5 Stone Ridge NY 12484-5613 |
| Mailing Address |
3669 Main St Ste 5 P.o. Box 894 Stone Ridge NY 12484-5613 |
| Practice Telephone | 8457847862 |
| Mailing Telephone | 8457847862 |
| Enumeration Date | 2014-10-02 |
| Last Update Date | 2014-10-02 |
| Authorized Official Name | DR. KENDRA LAUREN HAVEN (OWNER) |
| Authorized Official Telephone | 8457847862 |
| Authorized Official Credential | PH.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TC0700X |
Psychologist Specialization: Clinical |
NY | Behavioral Health & Social Service Providers |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| New York State Corporations | MINDHEALTH PSYCHOLOGICAL SERVICES, PLLC | 3669 Main Street Suite 5, Stone Ridge, Ny 12484 |
| Street Address |
3669 MAIN ST SUITE 5 |
| City | STONE RIDGE |
| State | NY |
| Zip Code | 12484-5613 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902214604 | Phillip Parker | Advanced Practice Dental Therapist | 3669 Main St, Stone Ridge, NY 12484-5613 | 2014-07-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669964706 | Hurley Avenue Family Medicine | Family Medicine | 10 Gagnon Dr., Stone Ridge, NY 12484 | 2018-06-05 |
| 1053691014 | Helena Nikolajevic | Acupuncturist | 24 Albright Lane, Stone Ridge, NY 12484 | 2011-08-23 |
| 1346532090 | Stone Ridge Chiropractic, PC | Chiropractor | 3631 Main Street, Stoneridge, NY 12484 | 2011-05-12 |
| 1760681829 | Elizabeth S Loughren | Registered Nurse | 766 Old Turnpike Rd, In Care of Dr Wm Thomas, Sherburne, NY 12484 | 2007-07-17 |
| 1457472789 | Sondra D. Tillou | Chiropractor | Rt. 209 & Mt. View, Stone Ridge, NY 12484 | 2007-04-03 |
| 1336269539 | Renee Gabrielle Sabin-haggerty | Pharmacist | 3852 Main St, Rite Aid Store #10704, Stone Ridge, NY 12484 | 2007-03-30 |
| 1114028818 | Eckerd Corporation | Durable Medical Equipment & Medical Supplies | 3852 Main Street, Stone Ridge, NY 12484 | 2006-09-26 |
| 1417967530 | Wayne William St Hill | Dentist | 10 Gagnon Drive, Rte 209, Stone Ridge, NY 12484 | 2006-08-09 |
| 1902897242 | Timothy E Deschenes | Chiropractor | Box 514, 3631 Main Street, Stone Ridge, NY 12484 | 2005-11-04 |
| 1023388147 | Alicia Ann Marquis-serson | Speech-Language Pathologist | 122 Kyserike Road, Stone Ridge, NY 12484 | 2012-01-05 |
| Find all providers in zip 12484 | ||||
| Taxonomy Code | 103TC0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184750184 | Frances Bryna Somerman | Psychologist | 40 Whitelands Rd, Stone Ridge, NY 12484-5833 | 2007-02-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396346060 | Alexandra Hittman | Psychologist | 26 Palisade St, Dobbs Ferry, NY 10522-2107 | 2020-11-07 |
| 1184225849 | Linda L Street | Psychologist | 165 Saint Regis Dr, Massapequa Park, NY 11762-3454 | 2020-11-07 |
| 1063012318 | Inga Korsgaard | Psychologist | 233 Broadway Rm 850, New York, NY 10279-0800 | 2020-10-27 |
| 1194324657 | Elizabeth Brunoski | Psychologist | 50 W 67th St Ste 5h, New York, NY 10023-6227 | 2020-10-25 |
| 1760081830 | Meagan Ryan | Psychologist | 1 3rd Ave Apt 516, Mineola, NY 11501-4340 | 2020-10-20 |
| 1912505587 | Elspeth Hayden Kelly | Psychologist | 519 8th Ave Fl 8, New York, NY 10018-6506 | 2020-10-15 |
| 1700484623 | Rena Lee Miller | Psychologist | 252 N 6th St Apt 17, Brooklyn, NY 11211-3367 | 2020-10-13 |
| 1558968842 | Ethan Eisen | Psychologist | 107 Lakeside Dr E, Lawrence, NY 11559-1718 | 2020-10-08 |
| 1790382398 | Katelynn Marie Faulkner | Psychologist | 1 Old Plank Rd # 1d, Clinton, NY 13323-1802 | 2020-10-06 |
| 1811594039 | Pinchus Feintuch | Psychologist | 1580 E 18th St Ste 101, Brooklyn, NY 11230-7261 | 2020-10-01 |
| Find all providers with the same taxonomy | ||||
| City | STONE RIDGE |
| Zip Code | 12484 |
Please comment or provide details below to improve the information on MINDHEALTH PSYCHOLOGICAL SERVICES, PLLC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.