NPIMap

Organization Active NPI

SRG Treatment Services Incorporated

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • West Sayville, NY
National Provider Identifier
1124706247
Registry record updated Jul 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Legal business name
SRG TREATMENT SERVICES INCORPORATED
Practice address
123 Carley Dr
West Sayville, NY 11796-1007
Phone
(631) 796-9641
NPI assigned
Jul 10, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2023

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

Authorized official

Name
Dr. Stephanie Anne Allen, PSY.D.NPI 1568853901
Title
President
Phone
(631) 796-9641

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X Primary

Addresses

Primary practice location

123 Carley Dr
West Sayville, NY 11796-1007

Mailing address

123 Carley Dr
West Sayville, NY 11796-1007
Phone (631) 796-9641

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1688947200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1688947200000",
    "number": "1124706247",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "123 CARLEY DR",
            "city": "WEST SAYVILLE",
            "state": "NY",
            "postal_code": "117961007",
            "telephone_number": "631-796-9641"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "123 CARLEY DR",
            "city": "WEST SAYVILLE",
            "state": "NY",
            "postal_code": "117961007",
            "telephone_number": "631-796-9641"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SRG TREATMENT SERVICES INCORPORATED",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-07-10",
        "last_updated": "2023-07-10",
        "certification_date": "2023-07-08",
        "status": "A",
        "authorized_official_last_name": "ALLEN",
        "authorized_official_first_name": "STEPHANIE",
        "authorized_official_middle_name": "ANNE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "631-796-9641",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSY.D."
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Sayville, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2023; 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.