Active Change Psychological Services, PLLC

Primary specialty

PsychologistTaxonomy code 103T00000X

Legal business name

ACTIVE CHANGE PSYCHOLOGICAL SERVICES, PLLC

Practice address

6800 Jericho Tpke Ste 120W
Syosset, NY 11791-4445

Phone

(516) 835-2048

NPI assigned

Jun 29, 2020

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Jay Evan Saul, PH.D.NPI 1841400538

Title

Member

Phone

(516) 835-2048

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jay Evan Saul, PH.D.

  • Psychologist
  • Syosset, NY
  • NPI 1841400538
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1593388800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1593388800000",
    "number": "1053938837",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6800 JERICHO TPKE STE 120W",
            "city": "SYOSSET",
            "state": "NY",
            "postal_code": "117914445",
            "telephone_number": "516-835-2048"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6800 JERICHO TPKE STE 120W",
            "city": "SYOSSET",
            "state": "NY",
            "postal_code": "117914445",
            "telephone_number": "516-835-2048"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ACTIVE CHANGE PSYCHOLOGICAL SERVICES, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-06-29",
        "last_updated": "2020-06-29",
        "certification_date": "2020-06-29",
        "status": "A",
        "authorized_official_last_name": "SAUL",
        "authorized_official_first_name": "JAY",
        "authorized_official_middle_name": "EVAN",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "516-835-2048",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael Abramowitz, DMD
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• Robert Ackerly, PT
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• Cerise Adams, DPM
• Erin Adams, LMSW
• Adetokunbo Tolulope Adewetan
• Emma Rose Adjobi, SERVICE COORDINATORS

• All providers in Syosset, NY
• Psychologist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.