| Michael Herships, Phd | |
|
222 E Middle Country Rd Ste 210 Smithtown NY 11787-2814 | |
| (631) 361-9338 | |
| (631) 653-1440 |
| Full Name | Michael Herships, Phd |
|---|---|
| Speciality | Clinic/Center |
| Location | 222 E Middle Country Rd Ste 210, Smithtown, New York |
| Authorized Official Name and Position | Michael Herships (CEO) |
| Authorized Official Contact | 6313619338 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Michael Herships, Phd 222 E Middle Country Rd Ste 210 Smithtown NY 11787-2814 Ph: (631) 361-9338 | Michael Herships, Phd 222 E Middle Country Rd Ste 210 Smithtown NY 11787-2814 Ph: (631) 361-9338 |
| NPI Number | 1578075040 |
|---|---|
| Provider Enumeration Date | 10/24/2017 |
| Last Update Date | 03/17/2018 |
| Medicare PECOS PAC ID | 7113283870 |
|---|---|
| Medicare Enrollment ID | O20171204001511 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1578075040 | NPI | - | NPPES |
| 01103433 | Medicaid | NY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | 008936 (New York) | Primary |
| Provider Name | Michael Herships |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1740378520 PECOS PAC ID: 2264468644 Enrollment ID: I20050718000321 |
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