| Amanda Grodewald-adler, Psy.d., Pllc | |
|
1919 Middle Country Rd Ste 308 Centereach NY 11720 | |
| (631) 209-5343 | |
| Not Available |
| Full Name | Amanda Grodewald-adler, Psy.d., Pllc |
|---|---|
| Speciality | Clinic/Center |
| Location | 1919 Middle Country Rd Ste 308, Centereach, New York |
| Authorized Official Name and Position | Amanda Lea Grodewald-adler (PSYCHOLOGIST) |
| Authorized Official Contact | 6312095343 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Amanda Grodewald-adler, Psy.d., Pllc 1919 Middle Country Rd Ste 308 Centereach NY 11720-3501 Ph: (631) 209-5343 | Amanda Grodewald-adler, Psy.d., Pllc 1919 Middle Country Rd Ste 308 Centereach NY 11720 Ph: (631) 209-5343 |
| NPI Number | 1154820553 |
|---|---|
| Provider Enumeration Date | 02/12/2018 |
| Last Update Date | 08/30/2018 |
| Medicare PECOS PAC ID | 7517216252 |
|---|---|
| Medicare Enrollment ID | O20180814002073 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154820553 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | 019388 (New York) | Primary |
| Provider Name | Amanda L Grodewald Adler |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1144520768 PECOS PAC ID: 9436310422 Enrollment ID: I20120419000040 |
East End Neurpsych Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 2539 Middle Country Rd Ste 4, Centereach, NY 11720 Phone: 631-737-6434 Fax: 631-738-1226 | |
Open-minded Marriage & Family Therapy, Pllc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 2100 Middle Country Rd Ste 211b, Centereach, NY 11720 Phone: 631-468-8587 | |
East End Neuropsychiatric Associates Pc Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 2539 Middle Country Rd, Suite 4, Centereach, NY 11720 Phone: 631-737-6434 Fax: 631-738-1226 | |
Manchandani Psychological Services, Pllc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1919 Middle Country Rd Ste 308, Centereach, NY 11720 Phone: 631-662-9049 | |
Diane O. Seaman, Lcsw Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 18 Forest Rd, Centereach, NY 11720 Phone: 631-648-7689 Fax: 631-648-7690 |