| Tru Outreach Inc | |
|
21 Ruland Rd Selden NY 11784-2301 | |
| (631) 740-2517 | |
| Not Available |
| Full Name | Tru Outreach Inc |
|---|---|
| Speciality | Psychologist |
| Location | 21 Ruland Rd, Selden, New York |
| Authorized Official Name and Position | Stephen Taylor (PRESIDENT) |
| Authorized Official Contact | 5167298606 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Tru Outreach Inc 21 Ruland Rd Selden NY 11784-2301 Ph: () - | Tru Outreach Inc 21 Ruland Rd Selden NY 11784-2301 Ph: (631) 740-2517 |
| NPI Number | 1740802198 |
|---|---|
| Provider Enumeration Date | 05/08/2020 |
| Last Update Date | 05/27/2020 |
| Certification Date | 05/27/2020 |
| Medicare PECOS PAC ID | 8820419401 |
|---|---|
| Medicare Enrollment ID | O20200608001050 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1740802198 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Secondary |
| 103T00000X | Psychologist | (* (Not Available)) | Primary |
| Provider Name | Stephen S Taylor |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1407298078 PECOS PAC ID: 0648691220 Enrollment ID: I20200608001349 |
Bashir Ahmed, M.d. Pllc Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 1305 Middle Country Rd, Suite #2, Selden, NY 11784 Phone: 631-320-3053 |