Provider Demographics
NPI:1316557606
Name:CALM MIND PSYCHIATRIC NP SERVICES OF THE FINGER LAKES PLLC
Entity Type:Organization
Organization Name:CALM MIND PSYCHIATRIC NP SERVICES OF THE FINGER LAKES PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:SHANNON
Authorized Official - Middle Name:
Authorized Official - Last Name:DRAKE
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:607-423-9304
Mailing Address - Street 1:5776 HOWELL RD
Mailing Address - Street 2:
Mailing Address - City:LOCKE
Mailing Address - State:NY
Mailing Address - Zip Code:13092-3351
Mailing Address - Country:US
Mailing Address - Phone:607-423-9304
Mailing Address - Fax:
Practice Address - Street 1:5776 HOWELL RD
Practice Address - Street 2:
Practice Address - City:LOCKE
Practice Address - State:NY
Practice Address - Zip Code:13092-3351
Practice Address - Country:US
Practice Address - Phone:607-423-9304
Practice Address - Fax:949-577-4133
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-03
Last Update Date:2021-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)