| Cultivate Psychological Services Pllc | |
|
100 S Jersey Ave Unit 21 East Setauket NY 11733-2036 | |
| (631) 213-7690 | |
| Not Available |
| Full Name | Cultivate Psychological Services Pllc |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 100 S Jersey Ave Unit 21, East Setauket, New York |
| Authorized Official Name and Position | Angela Turner Dougherty (SOLE MEMBER, LICENSED PSYCHOLOGIST) |
| Authorized Official Contact | 6312137690 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Cultivate Psychological Services Pllc 100 S Jersey Ave Unit 21 East Setauket NY 11733-2036 Ph: () - | Cultivate Psychological Services Pllc 100 S Jersey Ave Unit 21 East Setauket NY 11733-2036 Ph: (631) 213-7690 |
| NPI Number | 1003528803 |
|---|---|
| Provider Enumeration Date | 12/23/2022 |
| Last Update Date | 12/23/2022 |
| Certification Date | 12/23/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003528803 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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