| Ccms | |
|
25 Elm Pl Fl 2 Brooklyn NY 11201-5355 | |
| (718) 802-0666 | |
| (718) 858-9493 |
| Full Name | Ccms |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 25 Elm Pl Fl 2, Brooklyn, New York |
| Authorized Official Name and Position | Emory X. Brooks (PRESIDENT & CEO) |
| Authorized Official Contact | 7188020666 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Ccms 25 Elm Pl Fl 2 Brooklyn NY 11201-5355 Ph: (718) 802-0666 | Ccms 25 Elm Pl Fl 2 Brooklyn NY 11201-5355 Ph: (718) 802-0666 |
| NPI Number | 1003028549 |
|---|---|
| Provider Enumeration Date | 05/04/2007 |
| Last Update Date | 04/24/2018 |
| Medicare PECOS PAC ID | 5294960936 |
|---|---|
| Medicare Enrollment ID | O20131105000444 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003028549 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 7655100A (New York) | Primary |
| Provider Name | George Isaac |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1043279342 PECOS PAC ID: 9537056213 Enrollment ID: I20040228000324 |
| Provider Name | David Osman |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1841732278 PECOS PAC ID: 8527087329 Enrollment ID: I20051121000842 |
| Provider Name | Debra a Rock |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1346422367 PECOS PAC ID: 8325338668 Enrollment ID: I20160527001565 |
| Provider Name | Emilio M Iturrino |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1174806814 PECOS PAC ID: 7810280104 Enrollment ID: I20160725001109 |
| Provider Name | Digna E Reyes-marte |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1780253674 PECOS PAC ID: 8022404060 Enrollment ID: I20220331000653 |
| Provider Name | Cheri-ann J Clarke |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1669624433 PECOS PAC ID: 5092188789 Enrollment ID: I20230228000875 |
| Provider Name | Nataliya Bennett |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1366064644 PECOS PAC ID: 8729453477 Enrollment ID: I20230411000616 |
| Provider Name | Karen a Whittaker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760193262 PECOS PAC ID: 3779949458 Enrollment ID: I20230523000863 |
| Provider Name | Robert G Schley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245098979 PECOS PAC ID: 0345680419 Enrollment ID: I20240507000499 |
| Provider Name | Di Fan |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1851064018 PECOS PAC ID: 4789118852 Enrollment ID: I20241112002172 |
| Provider Name | Qinying Chu |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1235791948 PECOS PAC ID: 2961936042 Enrollment ID: I20241112002698 |
| Provider Name | Peiyi Zhou |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1275164600 PECOS PAC ID: 1355875444 Enrollment ID: I20241112002997 |
| Provider Name | Qingquan Yang |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1073166575 PECOS PAC ID: 2860926953 Enrollment ID: I20241112003178 |
| Provider Name | Beverly P Nedd |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396804209 PECOS PAC ID: 4789867847 Enrollment ID: I20250218000729 |
| Provider Name | Dorothy M Wohl |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1013142819 PECOS PAC ID: 6103335146 Enrollment ID: I20250602002690 |
| Provider Name | Andree M Henry |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386082204 PECOS PAC ID: 6608378286 Enrollment ID: I20250903004190 |
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