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Organization
UPSHUR BREN PSYCHOLOGY GROUP
Active
Organization
UPSHUR BREN PSYCHOLOGY GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ERIN SCHALLMOSER (INTAKE COORDINATOR/EXECUTIVE ASST.)
(813) 428-2122
Entity
Organization
Contact information
Practice address
629 FIFTH AVE STE 109, PELHAM, NY 10803-3708
(914) 368-2995
Mailing address
629 FIFTH AVE STE 109, PELHAM, NY 10803-3708
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
103T00000X
Psychologist
—
—
103TB0200X
Cognitive & Behavioral Psychologist
—
—
103TC0700X
Clinical Psychologist
Primary
—
—
103TC2200X
Clinical Child & Adolescent Psychologist
—
—
104100000X
Social Worker
—
—
1041C0700X
Clinical Social Worker
—
—
Other
Enumeration date
09/08/2023
Last updated
09/08/2023
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