Provider Demographics
NPI:1558801977
Name:MINDWELL PSYCHOLOGY NYC PLLC
Entity Type:Organization
Organization Name:MINDWELL PSYCHOLOGY NYC PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED CLINICAL PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:REBECCA
Authorized Official - Middle Name:
Authorized Official - Last Name:SKOLNICK
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:646-809-5440
Mailing Address - Street 1:80 8TH AVE
Mailing Address - Street 2:SUITE 711
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10011-5126
Mailing Address - Country:US
Mailing Address - Phone:646-809-5440
Mailing Address - Fax:
Practice Address - Street 1:80 8TH AVE
Practice Address - Street 2:SUITE 711
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10011-5126
Practice Address - Country:US
Practice Address - Phone:646-809-5440
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-04
Last Update Date:2018-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY021210103TC0700X
NY020696103TC0700X
NY021280103TC0700X
NY018408103TC0700X
NYP09302103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty