Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Well Child Psychiatric NP PLLC

Organization Psychiatric/Mental Health Nurse Practitioner · NPI 1508514340

Well Child Psychiatric NP PLLC is a Psychiatric/Mental Health Nurse Practitioner in Glens Falls, New York. Registered with an NPI since 2022.

In the registry since
2022
What do these letters mean?
PLLC — Professional limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

92 Broad St Fl 2
Glens Falls, NY 12801-4383
Phone: (518) 480-4002
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Psychiatric/Mental Health Nurse Practitioner (primary) Taxonomy 363LP0808X

Record details

NPI number1508514340
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Debbra Pedersen — Credentialing Specialist · (518) 631-8268
NPI enumeratedMarch 11, 2022
Last updated in NPPESMarch 11, 2022
Certification dateMarch 11, 2022
Mailing address92 Broad St Fl 2, Glens Falls, NY 12801-4383

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