| Catskill Mountain Psychology Pllc | |
|
159 Green St Kingston NY 12401-3736 | |
| (845) 331-2007 | |
| (845) 339-2382 |
| Full Name | Catskill Mountain Psychology Pllc |
|---|---|
| Speciality | Psychologist |
| Location | 159 Green St, Kingston, New York |
| Authorized Official Name and Position | Lawrence Dresdale (SOLE MEMBER) |
| Authorized Official Contact | 8453312007 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Catskill Mountain Psychology Pllc 50 Lauren Ct Kingston NY 12401-7207 Ph: (914) 388-9254 | Catskill Mountain Psychology Pllc 159 Green St Kingston NY 12401-3736 Ph: (845) 331-2007 |
| NPI Number | 1073992178 |
|---|---|
| Provider Enumeration Date | 05/21/2015 |
| Last Update Date | 09/21/2015 |
| Medicare PECOS PAC ID | 5193038792 |
|---|---|
| Medicare Enrollment ID | O20150724010593 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073992178 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | 7948 (New York) | Primary |
| Provider Name | Lawrence E Dresdale |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1689791352 PECOS PAC ID: 7214124767 Enrollment ID: I20101209000640 |
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