Provider Demographics
NPI:1558929711
Name:MANHATTAN THERAPY COLLECTIVE PSYCHOLOGICAL SERVICES, PLLC
Entity Type:Organization
Organization Name:MANHATTAN THERAPY COLLECTIVE PSYCHOLOGICAL SERVICES, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:PEGGY
Authorized Official - Middle Name:
Authorized Official - Last Name:LOO
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:212-271-0216
Mailing Address - Street 1:580 BROADWAY, MEZZANINE B SUITE
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10012
Mailing Address - Country:US
Mailing Address - Phone:212-271-0216
Mailing Address - Fax:
Practice Address - Street 1:580 BROADWAY, MEZZANINE B SUITE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10012-1001
Practice Address - Country:US
Practice Address - Phone:212-271-0216
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-06-03
Last Update Date:2019-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty