Provider Demographics
NPI:1881332948
Name:ENDWELL ASSOCIATES OF MENTAL HEALTH
Entity type:Organization
Organization Name:ENDWELL ASSOCIATES OF MENTAL HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RACHEL
Authorized Official - Middle Name:
Authorized Official - Last Name:RAPPAPORT
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:321-279-7140
Mailing Address - Street 1:3306 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:ENDWELL
Mailing Address - State:NY
Mailing Address - Zip Code:13760-5955
Mailing Address - Country:US
Mailing Address - Phone:321-279-7140
Mailing Address - Fax:
Practice Address - Street 1:3306 E MAIN ST
Practice Address - Street 2:
Practice Address - City:ENDWELL
Practice Address - State:NY
Practice Address - Zip Code:13760-5955
Practice Address - Country:US
Practice Address - Phone:607-444-2819
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-26
Last Update Date:2022-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty