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 |
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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 |
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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 |
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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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