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Organization
MENTALIST SPECIALTIES LLC
Active
Organization
MENTALIST SPECIALTIES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANASTASIA ANDERSON (OWNER)
(929) 757-3130
Entity
Organization
Contact information
Practice address
6 GRAMATAN AVE STE 606, MOUNT VERNON, NY 10550-3208
(929) 757-3130
Mailing address
48 CAPITOL AVE APT 2F, HARTFORD, CT 06106-9402
(929) 757-3130
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
NULL
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
03/11/2025
Last updated
03/24/2025
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