Provider Demographics
NPI:1639703481
Name:BROOKLYN INTEGRATIVE PSYCHOLOGICAL SERVICES, P.L.L.C.
Entity Type:Organization
Organization Name:BROOKLYN INTEGRATIVE PSYCHOLOGICAL SERVICES, P.L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MARIE
Authorized Official - Middle Name:
Authorized Official - Last Name:MERCADO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:646-807-9058
Mailing Address - Street 1:117 DOBBIN ST STE 210
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11222-2803
Mailing Address - Country:US
Mailing Address - Phone:646-807-9058
Mailing Address - Fax:646-396-0434
Practice Address - Street 1:117 DOBBIN ST STE 200
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11222-2803
Practice Address - Country:US
Practice Address - Phone:468-079-0586
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MARIE MERCADO, PSY.D.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-03-02
Last Update Date:2020-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty