Provider Demographics
NPI:1821699596
Name:SAINT PAUL, CALISSA (BSN-RN, PMHNP-BC)
Entity type:Individual
Prefix:
First Name:CALISSA
Middle Name:
Last Name:SAINT PAUL
Suffix:
Gender:
Credentials:BSN-RN, PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:261 SCHENECTADY AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11213-4286
Mailing Address - Country:US
Mailing Address - Phone:516-589-7819
Mailing Address - Fax:
Practice Address - Street 1:261 SCHENECTADY AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11213-4286
Practice Address - Country:US
Practice Address - Phone:516-589-7819
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-08
Last Update Date:2025-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY790772163W00000X
NY406738363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163W00000XNursing Service ProvidersRegistered Nurse