| Senior Behavioral Group, Inc. | |
|
18136 Kildare Rd Jamaica NY 11432-1534 | |
| (917) 312-5697 | |
| Not Available |
| Full Name | Senior Behavioral Group, Inc. |
|---|---|
| Speciality | Psychologist |
| Location | 18136 Kildare Rd, Jamaica, New York |
| Authorized Official Name and Position | Jennifer Rachel Levin (PRESIDENT) |
| Authorized Official Contact | 9173125697 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Senior Behavioral Group, Inc. 18136 Kildare Rd Jamaica NY 11432-1534 Ph: (917) 312-5697 | Senior Behavioral Group, Inc. 18136 Kildare Rd Jamaica NY 11432-1534 Ph: (917) 312-5697 |
| NPI Number | 1447852744 |
|---|---|
| Provider Enumeration Date | 11/11/2020 |
| Last Update Date | 12/14/2020 |
| Certification Date | 12/14/2020 |
| Medicare PECOS PAC ID | 6709299019 |
|---|---|
| Medicare Enrollment ID | O20210106000227 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1447852744 | NPI | - | NPPES |
| Provider Name | Jennifer R Levin |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1396851192 PECOS PAC ID: 3274568795 Enrollment ID: I20051003000823 |
| Provider Name | Bonnie Gerbitz |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1205505120 PECOS PAC ID: 2466859376 Enrollment ID: I20210920002725 |
| Provider Name | Miriam Shields |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1063983757 PECOS PAC ID: 2264822782 Enrollment ID: I20211123003236 |
| Provider Name | Laverne Edwards |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1457011348 PECOS PAC ID: 6507257409 Enrollment ID: I20220104001562 |
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