| Dr Michael Divak Psychologist | |
|
66 Montgomery St Ste 2 Canajoharie NY 13317-1212 | |
| (518) 673-6001 | |
| Not Available |
| Full Name | Dr Michael Divak Psychologist |
|---|---|
| Speciality | Psychologist - Clinical |
| Location | 66 Montgomery St Ste 2, Canajoharie, New York |
| Authorized Official Name and Position | Michael Norman Divak (SOLE PROPRIETOR) |
| Authorized Official Contact | 5186736001 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Michael Divak Psychologist 66 Montgomery St Canajoharie NY 13317-1212 Ph: (518) 673-6001 | Dr Michael Divak Psychologist 66 Montgomery St Ste 2 Canajoharie NY 13317-1212 Ph: (518) 673-6001 |
| NPI Number | 1679054167 |
|---|---|
| Provider Enumeration Date | 08/23/2018 |
| Last Update Date | 08/23/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1679054167 | NPI | - | NPPES |
| 846977 | Other | VA | BEACON HEALTH OPTIONS, INC |
| PRC200309433 | Other | NY | CAPITAL DISTRICT PHYSICIANS' HEALTH PLAN |
| 021046 | Other | NY | NEW YORK STATE OFFICE OF THE PROFESSIONS. LICENSE |
| 04054899 | Medicaid | NY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | 021046-1 (New York) | Primary |
Wandering Wellness Mental Health Counseling Pllc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 35 Cliff St, Suite 2, Canajoharie, NY 13317 Phone: 518-217-2838 | |
York Psychology, P.l.l.c. Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 66 Montgomery St, Canajoharie, NY 13317 Phone: 518-673-8060 Fax: 518-673-8061 |