SAMARITAN VILLAGE HARLEM OUTPATIENT (NPI# 1740650332) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1740650332 |
| Entity Type | Organization |
| Organization Name | SAMARITAN VILLAGE HARLEM OUTPATIENT |
| Practice Address |
55 W 125th St 11th Floor New York NY 10027-4516 |
| Practice Telephone | 2128644128 |
| Practice Fax Number | 2126629193 |
| Mailing Telephone | 2128644128 |
| Mailing Fax Number | 2126629193 |
| Enumeration Date | 2015-09-25 |
| Last Update Date | 2015-09-25 |
| Authorized Official Name | SHARON JOHNSON (CASEWORKER) |
| Authorized Official Telephone | 2128644128 |
| Authorized Official Credential | CASAC |
| Is Organization Subpart | Y |
| Parent Organization Name | SAMARITAN VILLAGE, INC. |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM0850X |
Clinic/Center Specialization: Adult Mental Health |
31027 | NY | Ambulatory Health Care Facilities |
| Street Address |
55 W 125TH ST 11TH FLOOR |
| City | NEW YORK |
| State | NY |
| Zip Code | 10027-4516 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992750392 | New York Vamc | Clinic/Center | 55 W 125th St, New York, NY 10027-4516 | 2006-05-23 |
| 1952853111 | Keith Short | Counselor | 55 W 125th St, 11th Floor, New York, NY 10027-4516 | 2016-11-03 |
| 1609327147 | Roberta Styles | Counselor | 55 W 125th St, 11th Floor, New York, NY 10027-4516 | 2016-10-19 |
| 1346798055 | Adriana Vargas | Counselor | 55 W 125th St, 11th Floor, New York, NY 10027-4516 | 2016-09-12 |
| 1144673005 | Quintin Fields | Counselor | 55 W 125th St, 11th Floor, New York, NY 10027-4516 | 2016-07-15 |
| 1285087148 | Briana Rodriguez | Counselor | 55 W 125th St, Floor 11, New York, NY 10027-4516 | 2016-07-15 |
| 1710345426 | Tracy Willet | Counselor | 55 W 125th St, 11th Floor, New York, NY 10027-4516 | 2016-02-09 |
| 1487011292 | Loren Barrie | Counselor | 55 W 125th St, 11th Floor, New York, NY 10027-4516 | 2016-01-25 |
| 1598121139 | Nicholas Elgar | Counselor | 55 W 125th St, 11th Floor, New York, NY 10027-4516 | 2016-01-12 |
| 1740646306 | Lina Torres | Counselor | 55 W 125th St, 11th Floor, New York, NY 10027-4516 | 2016-01-12 |
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|---|---|---|---|---|
| 1023616356 | Nathan Light | Dentist | M Dental Care PC, 337 Lenox Ave, New York, NY 10027 | 2020-10-09 |
| 1720691199 | Mohamad El Zein | Student in an Organized Health Care Education/Training Program | 281 West 132nd Street, App Nb 2, New York, NY 10027 | 2020-08-26 |
| 1194335893 | Cynthia Wiggins | Social Worker | 1255 Amsterdam Avenue, New York, NY 10027 | 2020-08-06 |
| 1497399877 | Dr. F Sanchez Dental Arts Pllc | Dentist | 2 Saint Nicholas Terrace, Store #1, New York, NY 10027 | 2019-10-29 |
| 1588214357 | Advanced Dermatology of New York PC | Dermatology | 1-3 West 125th Street, New York, NY 10027 | 2019-09-13 |
| 1396216818 | Gissel Lopez | Licensed Practical Nurse | 119west 124th Street, New York, NY 10027 | 2018-12-10 |
| 1831660620 | Katherine Gonzalez | Licensed Practical Nurse | 119 121 W 124th Street, New York, NY 10027 | 2018-12-06 |
| 1003383456 | Ebony S Prescott | Specialist | 2130 Adam Clayton Powell Blvd, Phenix Salon Suites, Suite #114, Ny, NY 10027 | 2018-10-24 |
| 1619456589 | Arts of Optics Corp. | Optometrist | 200 W 125th St, New York, NY 10027 | 2018-08-10 |
| 1205355658 | Frederick Community Pharmacy Inc | Pharmacy | 2450 Frederick Douglas Blvd, New York, NY 10027 | 2017-09-18 |
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| Taxonomy Code | 261QM0850X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Adult Mental Health |
| An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in adults. |
| Notes: [7/1/2003: new] |
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| 1407418379 | Housing Works Services, Inc. | Clinic/Center | 743- East 9th Street, Omh Department, New York, NY 10009 | 2019-07-01 |
| 1184196644 | Gab Brands, LLC | Clinic/Center | 505 W 54th St Apt 713, New York, NY 10019-5059 | 2018-12-21 |
| 1164994786 | Frameworks Counseling Lcsw P.C. | Clinic/Center | 125 E 23rd St Fl 5, New York, NY 10010-4581 | 2018-12-20 |
| 1265931984 | Nyc Therapeutic Wellness | Clinic/Center | 303 5th Ave Rm 606, New York, NY 10016-6685 | 2018-02-08 |
| 1447707146 | Gary M Prottas, Lcsw Psychotherapist Pllc | Clinic/Center | 20 West 20th Street, Room 239, New York, NY 10011-4313 | 2016-09-09 |
| 1881043370 | Margaret M. Rombone, Ph.d. | Clinic/Center | 51 E 25th St Ste 7h, New York, NY 10010-8209 | 2016-06-06 |
| 1003270224 | Peter Reznik | Clinic/Center | 1641 3rd Ave Ste 201, New York, NY 10128-3623 | 2016-04-13 |
| 1417313024 | Jerome Boling | Clinic/Center | 2090 7th Ave Fl 4, New York, NY 10027-4941 | 2016-01-12 |
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| 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.