Active NPI
Private Practice Psychiatry Services LLC
- Counselor
- Riverhead, NY
National Provider Identifier
1043869464
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- Legal business name
- PRIVATE PRACTICE PSYCHIATRY SERVICES LLC
- Practice address
- 67 E Main St
Riverhead, NY 11901-2422 - Phone
- (631) 392-4357
- Fax
- (631) 392-4358
- NPI assigned
- Sep 9, 2019
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Ms. Deborah Petry, LCSW-R
- Title
- Counselor
- Phone
- (631) 392-4357
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | Primary |
Addresses
Primary practice location
67 E Main St
Riverhead, NY 11901-2422
Mailing address
67 E Main St
Riverhead, NY 11901-2422
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1497856108 | Other | NY | COMMERICAL |
National Provider Directory
National Provider DirectoryLocations
67 E Main St
Riverhead, NY 11901
Phone (631) 392-4357
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Internal Medicine Physician
- White Plains, NY
- NPI 1609898246
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1567987200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1567987200000",
"number": "1043869464",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "67 E MAIN ST",
"city": "RIVERHEAD",
"state": "NY",
"postal_code": "119012422",
"fax_number": "631-392-4358"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "67 E MAIN ST",
"city": "RIVERHEAD",
"state": "NY",
"postal_code": "119012422",
"telephone_number": "631-392-4357",
"fax_number": "631-392-4358"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "PRIVATE PRACTICE PSYCHIATRY SERVICES LLC",
"organizational_subpart": "NO",
"enumeration_date": "2019-09-09",
"last_updated": "2019-09-09",
"status": "A",
"authorized_official_last_name": "PETRY",
"authorized_official_first_name": "DEBORAH",
"authorized_official_title_or_position": "COUNSELOR",
"authorized_official_telephone_number": "631-392-4357",
"authorized_official_name_prefix": "Ms.",
"authorized_official_credential": "LCSW-R"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Counselor",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "COMMERICAL",
"identifier": "1497856108",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Riverhead, NY
- Susan Popow, LCSW
- Roy Prashad, D.O.
- Michael John Pratt, LMSW
- Scott M. Press, MD FACS
- Priscilla a. Lingard, LCSW Casac P.C.
- Professional Occupational & Physical Therapy, PLLC
- Professional Orthopedic and Sports Physical Therapy, PC
- Prohealth Care Associates, LLP
- Prohealth Chiropractic Rehabilitation PC
- Prothera Medical
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.