Provider Demographics
NPI:1093510885
Name:CLOVER MENTAL HEALTH PSYCHIATRIC NURSING PC
Entity type:Organization
Organization Name:CLOVER MENTAL HEALTH PSYCHIATRIC NURSING PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BREANNA
Authorized Official - Middle Name:TAYLOR
Authorized Official - Last Name:SCIARRINO
Authorized Official - Suffix:
Authorized Official - Credentials:PMHNP
Authorized Official - Phone:585-555-5555
Mailing Address - Street 1:500 HELENDALE RD STE 155
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14609-3125
Mailing Address - Country:US
Mailing Address - Phone:585-555-5555
Mailing Address - Fax:
Practice Address - Street 1:500 HELENDALE RD STE 155
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14609-3125
Practice Address - Country:US
Practice Address - Phone:585-555-5555
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-02-15
Last Update Date:2025-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty