# LW NP PSYCHIATRY PC

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

## Provider details

- **NPI number:** 1417637042
- **Authorized official:** LAVERN WILSON-DENNIS (CEO)
- **Authorized official phone:** (646) 244-3196

## Contact information

- **Practice address:** 142 JORALEMON ST RM 5, BROOKLYN, NY 11201-4747
- **Practice address phone:** (646) 244-3196
- **Mailing address:** 1057 EASTERN PKWY APT 2D, BROOKLYN, NY 11213-4858

## Taxonomy

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

## Other

- **Enumeration date:** 07/19/2023
- **Last updated:** 12/04/2023