| Park Slope Psychological Services, Llc | |
|
319 18th St Apt 3a Brooklyn NY 11215-6109 | |
| (917) 545-7503 | |
| (800) 275-3671 |
| Full Name | Park Slope Psychological Services, Llc |
|---|---|
| Speciality | Psychologist - Clinical |
| Location | 319 18th St Apt 3a, Brooklyn, New York |
| Authorized Official Name and Position | Jacqueline Phung (PRESIDENT) |
| Authorized Official Contact | 8002753243 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Park Slope Psychological Services, Llc 319 18th St Apt 3a Brooklyn NY 11215-6109 Ph: (917) 545-7503 | Park Slope Psychological Services, Llc 319 18th St Apt 3a Brooklyn NY 11215-6109 Ph: (917) 545-7503 |
| NPI Number | 1609042621 |
|---|---|
| Provider Enumeration Date | 04/30/2008 |
| Last Update Date | 04/30/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1609042621 | NPI | - | NPPES |
| 02726185 | Medicaid | NY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | 016099-1 (New York) | Primary |
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