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PRIVATE PRACTICE PSYCHIATRY SERVICES LLC NPI 1043869464


NPI Information

NPI: 1043869464
Provider Name: PRIVATE PRACTICE PSYCHIATRY SERVICES LLC
Classification: Counselor - 101Y00000X
Entity Type: Organization
Address:
67 E MAIN ST
RIVERHEAD, NY
ZIP 11901
Phone: (631) 392-4357
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PRIVATE PRACTICE PSYCHIATRY SERVICES LLC is a counselor in Riverhead, NY. The provider is a provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master's degree and clinical experience and supervision for licensure or certification. PRIVATE PRACTICE PSYCHIATRY SERVICES LLC NPI is 1043869464. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

67 E MAIN ST
RIVERHEAD, NY
ZIP 11901-422
Phone: (631) 392-4357
Fax: (631) 392-4358

The provider's authorized official is Deborah Petry .
The authorized official title is Counselor and has the following contact phone number (631) 392-4357.

The enumeration date for this NPI number is 9/9/2019 and was last updated on 9/9/2019.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1101Y00000XCounselorYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
11497856108OTHERNEW YORKCOMMERICAL

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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