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SENIOR CONNECTIONS PSYCHOLOGICAL SE NPI 1265482491


NPI Information

NPI: 1265482491
Provider Name: SENIOR CONNECTIONS PSYCHOLOGICAL SE

Other Name: SENIOR CONNECTIONS PSYCHOLOGICAL SERVICES OF NEW YORK PC

Classification: Psychologist - 103TC0700X
Entity Type: Organization

Specialization: Clinical

Address:
270 RIVERSIDE DR.
#201
JOHNSON CITY, NY
ZIP 13790
Phone: (845) 781-6061
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SENIOR CONNECTIONS PSYCHOLOGICAL SE is a clinical psychologist in Johnson City, NY. The provider is a psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in breadth -- one that is broadly inclusive of severe psychopathology -- and marked by comprehensiveness and integration of knowledge and skill from a broad array of disciplines within and outside of psychology proper. The scope of clinical psychology encompasses all ages, multiple diversities and varied systems. SENIOR CONNECTIONS PSYCHOLOGICAL SE NPI is 1265482491. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Other Name Is Senior Connections Psychological Services Of New York Pc.

The provider's business location address is:

270 RIVERSIDE DR.
#201
JOHNSON CITY, NY
ZIP 13790
Phone: (845) 781-6061
Fax: (607) 729-0757

The provider's authorized official is Stephen Allen Daniel .
The authorized official title is Owner and has the following contact phone number (845) 781-6061.

The enumeration date for this NPI number is 5/10/2006 and was last updated on 10/11/2012.


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
11041C0700XSocial WorkerClinicalNo
2101YP2500XCounselorProfessionalNo
3103TC0700XPsychologistClinicalYes

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
1DD5776OTHERNEW YORKRAILROAD MEDICARE
202668179MEDICAIDNEW YORK
3BA0383MEDICARE PINNEW YORK
4WET291MEDICARE PINNEW YORK

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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