# CHRISTIAN WITHERELL NP IN PSYCHIATRY PLLC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1376314690
- **Authorized official:** CHRISTIAN WITHERELL PMHNP-BC (SOLE MEMBER)
- **Authorized official phone:** (631) 335-5541

## Contact information

- **Practice address:** 19995 SOUNDVIEW AVE, SOUTHOLD, NY 11971-2820
- **Practice address phone:** (631) 260-1326
- **Mailing address:** 19995 SOUNDVIEW AVE, SOUTHOLD, NY 11971-2820
- **Mailing address phone:** (631) 260-1326

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | — | Yes |

## Other

- **Enumeration date:** 01/15/2024
- **Last updated:** 01/15/2024