Provider Demographics
NPI:1386342517
Name:GROWTH WORK PSYCHOLOGY SERVICES PLLC
Entity type:Organization
Organization Name:GROWTH WORK PSYCHOLOGY SERVICES PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/LICENSED PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:MERCEDES
Authorized Official - Middle Name:J
Authorized Official - Last Name:OKOSI
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:646-822-4624
Mailing Address - Street 1:2374 ADAM CLAYTON POWELL JR BLVD APT 4
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10030-2202
Mailing Address - Country:US
Mailing Address - Phone:646-770-6922
Mailing Address - Fax:
Practice Address - Street 1:302 5TH AVE STE 811
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10001-3604
Practice Address - Country:US
Practice Address - Phone:646-822-4624
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-16
Last Update Date:2023-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-SpecialtyGroup - Multi-Specialty