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FATIMA ODETALLA, NP IN PSYCHIATRY, PLLC
NPI 1639771744
Nurse Practitioner - Psychiatric/Mental Health in Nyack, NY

Active since November 13, 2020
99 MAIN ST STE 302, NYACK, NY 10960(901) 590-7680 Get Directions Write a Review

NPPES record last updated: November 13, 2020. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Fatima Odetalla, Np In Psychiatry, Pllc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

FATIMA ODETALLA, NP IN PSYCHIATRY, PLLC (NPI 1639771744), doing business as Lighthouse Behavioral Health, is a healthcare organization registered as a psychiatric/mental health in Nyack, New York and active in the NPI registry since November 2020. The organization lists Fatima Odetalla, Owner, as its authorized official.

NPPES Registry Identity

NPI1639771744
Entity TypeOrganization
Primary Taxonomy363LP0808X
Legal Business NameFATIMA ODETALLA, NP IN PSYCHIATRY, PLLC
Location Address99 MAIN ST STE 302Nyack, NY 10960-3109
Mailing Address65 E Maltbie AveSuffern, NY 10901-6007
Phone(901) 590-7680
Organization SubpartNo
Authorized OfficialFatima OdetallaOwner · (901) 590-7680
Enumeration DateNovember 13, 2020
NPPES CertifiedNovember 13, 2020
✔ NPI 1639771744 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse Practitioner · Psychiatric/Mental HealthPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LP0808X
Also ListedNurse Practitioner · FamilyTaxonomy 363LF0000X
99 MAIN ST STE 302, Nyack, NY 10960
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Other Names 1

Doing Business AsLighthouse Behavioral Health

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Fatima Odetalla, Np In Psychiatry, PLLC's NPI number?

The NPI number for Fatima Odetalla, Np In Psychiatry, PLLC is 1639771744. It was assigned to this organization in the NPPES registry on November 13, 2020. The provider is doing business as Lighthouse Behavioral Health.

Where is Fatima Odetalla, Np In Psychiatry, PLLC located?

Fatima Odetalla, Np In Psychiatry, PLLC is located at 99 Main St Ste 302, Nyack, NY 10960. The listed phone number is (901) 590-7680.

What is Fatima Odetalla, Np In Psychiatry, PLLC's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.

When was this NPI record last updated?

The NPPES record for Fatima Odetalla, Np In Psychiatry, PLLC was last updated on November 13, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.