| Octave Psychiatry Behavioral Health Pc | |
|
45 E 20th St Fl 6 New York NY 10003 | |
| (415) 360-3833 | |
| (628) 234-3048 |
| Full Name | Octave Psychiatry Behavioral Health Pc |
|---|---|
| Speciality | Psychologist |
| Location | 45 E 20th St Fl 6, New York, New York |
| Authorized Official Name and Position | Kym Everett (VP REVENUE OPERATIONS) |
| Authorized Official Contact | 6505042289 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Octave Psychiatry Behavioral Health Pc Po Box 18397 Palatine IL 60055-8397 Ph: (415) 360-3833 | Octave Psychiatry Behavioral Health Pc 45 E 20th St Fl 6 New York NY 10003 Ph: (415) 360-3833 |
| NPI Number | 1821573023 |
|---|---|
| Provider Enumeration Date | 10/03/2018 |
| Last Update Date | 04/24/2025 |
| Certification Date | 04/24/2025 |
| Medicare PECOS PAC ID | 8022527324 |
|---|---|
| Medicare Enrollment ID | O20250529003223 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1821573023 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | (* (Not Available)) | Primary |
| Provider Name | Melissa Kwiatkowski |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1093162984 PECOS PAC ID: 8628587946 Enrollment ID: I20250529003414 |
| Provider Name | Vishal Vijay Vaswani |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1063844975 PECOS PAC ID: 3870002108 Enrollment ID: I20250529003672 |
| Provider Name | Samantha Alana Sampath |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1992308555 PECOS PAC ID: 7618486952 Enrollment ID: I20250529003819 |
| Provider Name | Heather Sutter |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1073998977 PECOS PAC ID: 1456860675 Enrollment ID: I20250530001417 |
| Provider Name | Kathleen Hariett Moran |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1750669867 PECOS PAC ID: 4284143413 Enrollment ID: I20250530001683 |
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