Organization
REVELATION PILGRIM MENTAL HEALTH SERVICES
Active
Other names
Revelation Pilgrim Mental Health
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RAYMOND H RUFEN-BLANCHETTE DD; PHD (PRESIDENT/CEO/DIRECTOR)
(347) 623-2110
Entity
Organization
Contact information
Practice address
14932 83RD ST, SUITE 100, HOWARD BEACH, NY 11414-1207
(347) 623-2110
(877) 278-5969
Mailing address
14932 83RD ST, SUITE 100, HOWARD BEACH, NY 11414-1207
(347) 623-2110
(877) 278-5969
Taxonomy
Speciality
Code
Description
License number
State
101YP1600X
Pastoral Counselor
Primary
EXEMPT PRACTITIONER
NY
102L00000X
Psychoanalyst
EXEMPT PRACTITIONER
NY
103TA0700X
Adult Development & Aging Psychologist
EXEMPT PRACTITIONER
NY
103TC1900X
Counseling Psychologist
EXEMPT PRACTITIONER
NY
103TC2200X
Clinical Child & Adolescent Psychologist
EXEMPT PRACTITIONER
NY
103TE1100X
Exercise & Sports Psychologist
EXEMPT PRACTITIONER
NY
103TF0000X
Family Psychologist
EXEMPT PRACTITIONER
NY
103TF0200X
Forensic Psychologist
EXEMPT PRACTITIONER
NY
103TP0814X
Psychoanalysis Psychologist
EXEMPT PRACTITIONER
NY
103TP2701X
Group Psychotherapy Psychologist
EXEMPT PRACTITIONER
NY
103TR0400X
Rehabilitation Psychologist
EXEMPT PRACTITIONER
NY
103TS0200X
School Psychologist
EXEMPT PRACTITIONER
NY
106H00000X
Marriage & Family Therapist
EXEMPT PRACTITIONER
NY
Other
Enumeration date
11/03/2009
Last updated
06/29/2010
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