Provider Demographics
NPI:1295504108
Name:DRGS PSYCH LLC
Entity type:Organization
Organization Name:DRGS PSYCH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:KARYN
Authorized Official - Middle Name:AND TIM
Authorized Official - Last Name:GUNNET-SHOVAL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:646-330-1036
Mailing Address - Street 1:155 W 70TH ST # 6BC
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10023-4419
Mailing Address - Country:US
Mailing Address - Phone:570-762-2307
Mailing Address - Fax:
Practice Address - Street 1:155 W 70TH ST # 6BC
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10023-4419
Practice Address - Country:US
Practice Address - Phone:570-762-2307
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-12-20
Last Update Date:2023-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounselingGroup - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty