Provider Demographics
NPI:1417133836
Name:POSTGRADUATE CENTER FOR MENTAL HEALTH
Entity type:Organization
Organization Name:POSTGRADUATE CENTER FOR MENTAL HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COORDINATOR OF CDT
Authorized Official - Prefix:MS
Authorized Official - First Name:BONNIE
Authorized Official - Middle Name:MILLER
Authorized Official - Last Name:LADDS
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:212-560-6774
Mailing Address - Street 1:344 W. 36TH ST
Mailing Address - Street 2:P.G.C.M.H.
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10018-3850
Mailing Address - Country:US
Mailing Address - Phone:212-560-6774
Mailing Address - Fax:
Practice Address - Street 1:344 W. 36TH STREET
Practice Address - Street 2:P.G.C.M.H.
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10018-3850
Practice Address - Country:US
Practice Address - Phone:212-560-6774
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-16
Last Update Date:2008-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR037062251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health