| Advanced Center For Psychotherapy, Inc. | |
|
17810 Wexford Ter Jamaica NY 11432-3050 | |
| (718) 658-1123 | |
| Not Available |
| Full Name | Advanced Center For Psychotherapy, Inc. |
|---|---|
| Speciality | Clinic/Center |
| Location | 17810 Wexford Ter, Jamaica, New York |
| Authorized Official Name and Position | Mounir Doss (CFO) |
| Authorized Official Contact | 7182066000 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Advanced Center For Psychotherapy, Inc. 80 Marcus Dr Provider Enrollment Melville NY 11747-4230 Ph: (631) 391-7889 | Advanced Center For Psychotherapy, Inc. 17810 Wexford Ter Jamaica NY 11432-3050 Ph: (718) 658-1123 |
| NPI Number | 1346261666 |
|---|---|
| Provider Enumeration Date | 07/21/2006 |
| Last Update Date | 01/30/2023 |
| Certification Date | 01/30/2023 |
| Medicare PECOS PAC ID | 7113918087 |
|---|---|
| Medicare Enrollment ID | O20040519001475 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1346261666 | NPI | - | NPPES |
| 00245836 | Medicaid | NY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Deepak Sankholkar |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1598828808 PECOS PAC ID: 0042202400 Enrollment ID: I20040402001107 |
| Provider Name | Daniel C Chen |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1285710038 PECOS PAC ID: 6800878646 Enrollment ID: I20040604000131 |
| Provider Name | Linda C Turner Booth |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1598816134 PECOS PAC ID: 5991772139 Enrollment ID: I20040915001207 |
| Provider Name | Margarita D Perez |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1811199342 PECOS PAC ID: 9335199660 Enrollment ID: I20050125000651 |
| Provider Name | Delores J Murphy-cassidy |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1477678761 PECOS PAC ID: 9335168806 Enrollment ID: I20051114000807 |
| Provider Name | Sylvia Indio |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1619033198 PECOS PAC ID: 1850493578 Enrollment ID: I20070227000705 |
| Provider Name | Arlene Noble |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1528139334 PECOS PAC ID: 6800985268 Enrollment ID: I20071207000674 |
| Provider Name | Shagufta Paya |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1750474805 PECOS PAC ID: 7214020270 Enrollment ID: I20071217000092 |
| Provider Name | Dinshaw D Bamji |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1831271774 PECOS PAC ID: 9638254501 Enrollment ID: I20080317000665 |
| Provider Name | Shushan Hovanesian |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1205973807 PECOS PAC ID: 2668543968 Enrollment ID: I20080613000282 |
| Provider Name | Marie R Pierre-louis |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1437356334 PECOS PAC ID: 9638246150 Enrollment ID: I20080925000582 |
| Provider Name | Blair Skolnick |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1619039310 PECOS PAC ID: 4880741263 Enrollment ID: I20090422000422 |
| Provider Name | Daniel Khaimov |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1518912583 PECOS PAC ID: 3577610955 Enrollment ID: I20090422000456 |
| Provider Name | Julie Alexander |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1154564466 PECOS PAC ID: 0446303630 Enrollment ID: I20090805000740 |
| Provider Name | Sandip P Sheth |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1972548915 PECOS PAC ID: 1355485806 Enrollment ID: I20100222000262 |
| Provider Name | Attilio Rizzo |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1932265972 PECOS PAC ID: 8527196872 Enrollment ID: I20100507000281 |
| Provider Name | Sheldon Schwartz |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1467506998 PECOS PAC ID: 6901938406 Enrollment ID: I20100720000123 |
| Provider Name | Madhu B Malhotra |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1558307041 PECOS PAC ID: 5395930317 Enrollment ID: I20101116000317 |
| Provider Name | Phoebe C Frankel |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1477604858 PECOS PAC ID: 0042492324 Enrollment ID: I20110311000060 |
| Provider Name | Sachidanand R Peteru |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1639321268 PECOS PAC ID: 6901089085 Enrollment ID: I20110328000299 |
| Provider Name | Sharmeen Sultana |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1588726285 PECOS PAC ID: 4486837226 Enrollment ID: I20110331000567 |
| Provider Name | Saloni M Wadia |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1700117058 PECOS PAC ID: 8628252699 Enrollment ID: I20110415000491 |
| Provider Name | Rose Michael |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1942597638 PECOS PAC ID: 0547427569 Enrollment ID: I20120202000731 |
| Provider Name | Jason M Chernikoff |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1053686055 PECOS PAC ID: 7719140458 Enrollment ID: I20120517000005 |
| Provider Name | Michelle A Defreitas |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1134364417 PECOS PAC ID: 1658526777 Enrollment ID: I20130221000116 |
| Provider Name | Kamalendra Sen |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1376987008 PECOS PAC ID: 6507188513 Enrollment ID: I20141202001937 |
| Provider Name | Kathleen E Halley |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1043540040 PECOS PAC ID: 5698097012 Enrollment ID: I20141212002181 |
| Provider Name | Tobie Aronson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1609283803 PECOS PAC ID: 1355642216 Enrollment ID: I20151217001722 |
| Provider Name | Tracey G Hughes |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1982974986 PECOS PAC ID: 6002108958 Enrollment ID: I20160713001020 |
| Provider Name | Sridevi Lokasubramanian |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1285022087 PECOS PAC ID: 3971889973 Enrollment ID: I20170405001424 |
| Provider Name | Andrew Paul Benevento |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1316227218 PECOS PAC ID: 6204108798 Enrollment ID: I20170817003290 |
| Provider Name | Michael B Braverman |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1811243421 PECOS PAC ID: 0648546291 Enrollment ID: I20171025003186 |
| Provider Name | Lindsay H Cohen |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1851788830 PECOS PAC ID: 8921364142 Enrollment ID: I20171103001632 |
| Provider Name | Michelle A Crowe |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1811497142 PECOS PAC ID: 1456606128 Enrollment ID: I20180620002525 |
| Provider Name | Ateaya A Lima |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1912226069 PECOS PAC ID: 7618227869 Enrollment ID: I20180910000216 |
| Provider Name | Marissa Vicari |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1710495981 PECOS PAC ID: 7214369016 Enrollment ID: I20191116000117 |
| Provider Name | Chevon L Roberts |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1609192947 PECOS PAC ID: 1951734805 Enrollment ID: I20191206000220 |
| Provider Name | Felicia A Hassan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1154767499 PECOS PAC ID: 4981023652 Enrollment ID: I20200929003013 |
| Provider Name | Steven Reshey |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1639619521 PECOS PAC ID: 8325453251 Enrollment ID: I20210226000683 |
| Provider Name | Mohanraj Rahiman |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1528516051 PECOS PAC ID: 0042628703 Enrollment ID: I20210416001939 |
| Provider Name | Sosan Kuriyan |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1568999860 PECOS PAC ID: 9638572332 Enrollment ID: I20210719001682 |
| Provider Name | Ksenia S Pillai |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1336657725 PECOS PAC ID: 0244575470 Enrollment ID: I20211208000452 |
| Provider Name | Amrita Sen |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1851970248 PECOS PAC ID: 7618360900 Enrollment ID: I20220209001539 |
| Provider Name | Tanya M Sydnor Holmes |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114525961 PECOS PAC ID: 9234519778 Enrollment ID: I20220630001580 |
| Provider Name | Natacha Joseph |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417527052 PECOS PAC ID: 6406231737 Enrollment ID: I20220922000645 |
| Provider Name | Shi Yun Li |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1164803987 PECOS PAC ID: 5294160271 Enrollment ID: I20230321002125 |
| Provider Name | Alyshiann Taylor |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1861716763 PECOS PAC ID: 5597127365 Enrollment ID: I20230810000869 |
| Provider Name | Inna Subotin |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1174749188 PECOS PAC ID: 9537506662 Enrollment ID: I20240325001101 |
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