| Child And Family Psychological Services Pc | |
|
521 Route 111 Ste 202 Hauppauge NY 11788-4358 | |
| (631) 265-9850 | |
| (631) 265-9852 |
| Full Name | Child And Family Psychological Services Pc |
|---|---|
| Speciality | Clinic/Center |
| Location | 521 Route 111 Ste 202, Hauppauge, New York |
| Authorized Official Name and Position | Kristie Doheny (OWNER) |
| Authorized Official Contact | 6312659850 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Child And Family Psychological Services Pc 521 Route 111 Ste 202 Hauppauge NY 11788-4358 Ph: (631) 265-9850 | Child And Family Psychological Services Pc 521 Route 111 Ste 202 Hauppauge NY 11788-4358 Ph: (631) 265-9850 |
| NPI Number | 1801493366 |
|---|---|
| Provider Enumeration Date | 10/07/2020 |
| Last Update Date | 07/03/2024 |
| Certification Date | 07/03/2024 |
| Medicare PECOS PAC ID | 3870026222 |
|---|---|
| Medicare Enrollment ID | O20241024000737 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1801493366 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Kristie Doheny |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1225361421 PECOS PAC ID: 1951834308 Enrollment ID: I20241024001010 |
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