Provider Demographics
NPI:1962023168
Name:BRAND THERAPY PSYCHOLOGICAL SERVICES PC
Entity Type:Organization
Organization Name:BRAND THERAPY PSYCHOLOGICAL SERVICES PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JURACI
Authorized Official - Middle Name:MARIA
Authorized Official - Last Name:LOPES DA SILVA
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:917-903-5067
Mailing Address - Street 1:50 WEST 39TH ST
Mailing Address - Street 2:SUITE 305
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10018
Mailing Address - Country:US
Mailing Address - Phone:917-677-9070
Mailing Address - Fax:917-725-8044
Practice Address - Street 1:50 WEST 39TH ST
Practice Address - Street 2:SUITE 305
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10018
Practice Address - Country:US
Practice Address - Phone:917-677-9070
Practice Address - Fax:917-725-8044
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-04-29
Last Update Date:2020-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TH0004XBehavioral Health & Social Service ProvidersPsychologistHealthGroup - Multi-Specialty