Provider Demographics
NPI:1225302599
Name:2ND CITY PSYCHOLOGICAL CONSULTING SERVICES, PLLC
Entity Type:Organization
Organization Name:2ND CITY PSYCHOLOGICAL CONSULTING SERVICES, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER
Authorized Official - Prefix:DR
Authorized Official - First Name:REON
Authorized Official - Middle Name:
Authorized Official - Last Name:BAIRD
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:914-712-8771
Mailing Address - Street 1:60 E 42ND ST
Mailing Address - Street 2:SUITE 1060
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10165-0006
Mailing Address - Country:US
Mailing Address - Phone:914-712-8771
Mailing Address - Fax:
Practice Address - Street 1:60 E 42ND ST
Practice Address - Street 2:SUITE 1060
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10165-0006
Practice Address - Country:US
Practice Address - Phone:914-712-8771
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-02
Last Update Date:2012-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY017751-1251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health