1861802795 NPI number — CITY AND COUNTRY PSYCHOLOGY PLLC

Table of content: MRS. ANDRIANNA MICHELLE LINDER BSW (NPI 1013292903)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1861802795 NPI number — CITY AND COUNTRY PSYCHOLOGY PLLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CITY AND COUNTRY PSYCHOLOGY PLLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
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Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
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Provider Other Last Name:
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NPI Number Information

NPI Number:
1861802795
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/19/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
10 PARK AVE
Provider Second Line Business Mailing Address:
SUITE 2D
Provider Business Mailing Address City Name:
NEW YORK
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
10016-4338
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
10 PARK AVE
Provider Second Line Business Practice Location Address:
SUITE 2D
Provider Business Practice Location Address City Name:
NEW YORK
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10016-4338
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
347-746-8396
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
04/30/2014

Additional Information

Authorized Official

Authorized Official Last Name:
GROVES
Authorized Official First Name:
SAMEENA
Authorized Official Middle Name:
Authorized Official Title or Position:
PSYCHOLOGIST
Authorized Official Telephone Number:
917-397-3921

Provider Taxonomy Codes

  • Taxonomy code: 103TC0700X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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