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MONDERRICK WILLIS
NPI 1982470266
Counselor - Addiction (Substance Use Disorder) in New York, NY

Active since November 28, 2023
394 BROADWAY FL 4, NEW YORK, NY 10013(718) 516-6007(212) 584-5450 Get Directions Write a Review

NPPES record last updated: November 28, 2023. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Monderrick Willis NPPES

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

MONDERRICK WILLIS (NPI 1982470266) is an individual addiction (substance use disorder) provider in New York, New York, licensed in New York (39117) and active in the NPI registry since November 2023.

NPPES Registry Identity

NPI1982470266
Entity TypeIndividualMale
Primary Taxonomy101YA0400X
Provider Legal NameMONDERRICK WILLIS
Location Address394 BROADWAY FL 4New York, NY 10013-6023
Mailing Address394 Broadway Fl 4New York, NY 10013-6023 · (718) 514-6007
Phone(718) 516-6007
Fax(212) 584-5450
Sole ProprietorNo
Enumeration DateNovember 28, 2023
NPPES CertifiedNovember 28, 2023
✔ NPI 1982470266 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · Addiction (Substance Use Disorder)Behavioral Health & Social Service Providers
Taxonomy Code101YA0400X
License✔ Licensed in NY · 39117
394 BROADWAY FL 4, New York, NY 10013
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Other Providers at the Same Location NPPES 12

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MRS. SABINA AMANDA NADEEM
Social Worker
394 BROADWAY FL 4
NEW YORK, NY 10013
New York County (212) 966-9537
JAMIE GORDON
Counselor (Mental Health)
394 BROADWAY FL 4
NEW YORK, NY 10013
New York County (212) 966-9537
LARISA CARABALLO JIMENEZ
Counselor (Addiction (Substance Use Disorder))
394 BROADWAY FL 4
NEW YORK, NY 10013
New York County (212) 966-9537
INNA R RAYKHELGAUZ FNP
Nurse Practitioner (Family)
394 BROADWAY FL 4
NEW YORK, NY 10013
New York County (212) 966-9537
JOB ETHAN CHRISTENSON
Social Worker
394 BROADWAY FL 4
NEW YORK, NY 10013
New York County (212) 966-9537
ASHLEE TAHIRA SMITH
Counselor (Addiction (Substance Use Disorder))
394 BROADWAY FL 4
NEW YORK, NY 10013
New York County (212) 966-9537
JOYCE KIMBERLY AMEN
Counselor (Addiction (Substance Use Disorder))
394 BROADWAY FL 4
NEW YORK, NY 10013
New York County (212) 966-9537
ANASTASIA CHERNYAKHOVSKY
Counselor (Addiction (Substance Use Disorder))
394 BROADWAY FL 4
NEW YORK, NY 10013
New York County (212) 966-9537

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 Monderrick Willis's NPI number?

The NPI number for Monderrick Willis is 1982470266. It was assigned to this individual provider in the NPPES registry on November 28, 2023.

Where is Monderrick Willis located?

Monderrick Willis practices at 394 Broadway Fl 4, New York, NY 10013. The listed phone number is (718) 516-6007.

What is Monderrick Willis's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Addiction (Substance Use Disorder), with taxonomy code 101YA0400X.

When was this NPI record last updated?

The NPPES record for Monderrick Willis was last updated on November 28, 2023. NPI Profile syncs with the weekly NPPES data releases published by CMS.