| Talkspace Provider Network Mi, Pc | |
|
2578 Broadway # 607 New York NY 10025-5642 | |
| (212) 284-7206 | |
| Not Available |
| Full Name | Talkspace Provider Network Mi, Pc |
|---|---|
| Speciality | Clinic/Center |
| Location | 2578 Broadway # 607, New York, New York |
| Authorized Official Name and Position | Nikole Benders-hadi (AUTHORIZED OFFICIAL) |
| Authorized Official Contact | 2122847206 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Talkspace Provider Network Mi, Pc Po Box 659 Portsmouth NH 03802-0659 Ph: (212) 284-7206 | Talkspace Provider Network Mi, Pc 2578 Broadway # 607 New York NY 10025-5642 Ph: (212) 284-7206 |
| NPI Number | 1033999800 |
|---|---|
| Provider Enumeration Date | 09/29/2023 |
| Last Update Date | 01/28/2025 |
| Certification Date | 01/28/2025 |
| Medicare PECOS PAC ID | 3971034638 |
|---|---|
| Medicare Enrollment ID | O20241004001991 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1033999800 | NPI | - | NPPES |
| Provider Name | Daphne Hamburg |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1821588484 PECOS PAC ID: 8921420340 Enrollment ID: I20200611002949 |
| Provider Name | Maxie L Mcnair |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1922613405 PECOS PAC ID: 1850752866 Enrollment ID: I20230807001407 |
| Provider Name | Cheri Dod-good |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1245886548 PECOS PAC ID: 5294171294 Enrollment ID: I20240313001197 |
| Provider Name | Angela M Mcnally |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1962830265 PECOS PAC ID: 7315478070 Enrollment ID: I20241004002046 |
| Provider Name | Mary Raymond |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1912479544 PECOS PAC ID: 6608398540 Enrollment ID: I20250319004182 |
| Provider Name | Nichole Louise Garcia |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1518483759 PECOS PAC ID: 9638692429 Enrollment ID: I20250402002269 |
| Provider Name | Jenette Bongiorno Smith |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1972871549 PECOS PAC ID: 8224552450 Enrollment ID: I20250409003259 |
| Provider Name | Derrick A Mason |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1780901983 PECOS PAC ID: 5597283606 Enrollment ID: I20250513001203 |
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