| North Coast Psychological Services, Pllc | |
|
575 Underhill Blvd Ste 114 Syosset NY 11791-3431 | |
| (516) 551-3153 | |
| Not Available |
| Full Name | North Coast Psychological Services, Pllc |
|---|---|
| Speciality | Psychologist - Clinical Child & Adolescent |
| Location | 575 Underhill Blvd Ste 114, Syosset, New York |
| Authorized Official Name and Position | Carolyn E Waldecker (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 5165513153 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| North Coast Psychological Services, Pllc 575 Underhill Blvd Ste 114 Syosset NY 11791-3431 Ph: () - | North Coast Psychological Services, Pllc 575 Underhill Blvd Ste 114 Syosset NY 11791-3431 Ph: (516) 551-3153 |
| NPI Number | 1588170971 |
|---|---|
| Provider Enumeration Date | 12/20/2017 |
| Last Update Date | 11/29/2021 |
| Certification Date | 11/29/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1588170971 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TB0200X | Psychologist - Cognitive & Behavioral | 022047 (New York) | Secondary |
| 103TC2200X | Psychologist - Clinical Child & Adolescent | 019641 (New York) | Primary |
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