Supportive Care Psychology of Ny PC
Organization Active NPI Clinical Psychologist · Howell, NJ
NPI 1104315068 · NPPES record last updated May 7, 2018
Key facts
- NPI
- 1104315068
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Clinical Psychologist 103TC0700X
- Legal business name
- SUPPORTIVE CARE PSYCHOLOGY OF NY PC
- Practice address
- 27 Randolph Rd
Howell, NJ 07731-8611 - Phone
- (718) 298-4375
- NPI assigned
- May 7, 2018
- Organization subpart
- No
Authorized official
- Name
- Jonathan Ausubel, PH.D.
- Title
- Authorized Official
- Phone
- (718) 298-4375
Practitioners 162
-
Elizabeth Duncan, LCSW
-
Rebecca Elisa Mischel, PSYD
-
Juan J Almanzar, LCSW
-
Diana Burgrave, LCSW R
-
Angela G Carr, PH.D.
-
Sharise Christian, LCSW
-
Lisa M Doce, LCSW-R
-
Nadine Eiring, CSW
-
Michelle Ijeoma Emode, LMHC
-
Heather Erbland, LCSW
-
Julson Fabien, LCSW
-
Leonard Fraser, MSW
-
Adam Gottlieb, MS
-
Adina Kayla Hardoon, LCSW
-
Paul S Kleinman, PH.D.
-
Arthur David Lewis, PSYD
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NY
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20180703001311 | NY | Part B Supplier - Clinic/Group Practice | 0749536852 | Receives reassigned benefits from 158 practitioners |
National Provider Directory
Locations
128 Main St
Camden, NY 13316
Phone (315) 245-1520
28 Kellogg Rd
Cortland, NY 13045
Phone (607) 753-6060
60 Merrick Ave
East Meadow, NY 11554
Phone (516) 222-9300
9131 175th St
Jamaica, NY 11432
Phone (340) 709-3133
1550 Herkimer Rd
Utica, NY 13502
Phone (315) 732-1594
105 W Sheedy Rd
Vestal, NY 13850
Phone (607) 754-4105
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist |
103TC0700X | Yes |
Addresses
Primary practice location
27 Randolph Rd
Howell, NJ 07731-8611
Mailing address
27 Randolph Rd
Howell, NJ 07731-8611
Phone (718) 298-4375
Other providers in Howell, NJ
- Strong for Life Therapy & Wellness, P.C.
- Jialin Su
- David A Sullivan
- Sunrise Surgical & Medical Supplies,LLC
- Supportive Care Psychology of NJ PC
- Lori Ann Sweetwood
- Mary Sznyter
- Victoria Talbot
- Christina Tallone
- Melissa Tasy
All providers in Howell, NJ · Clinical Psychologist in New Jersey
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 7, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.