NPIMap

Organization Active NPI

Cognitive-Behavioral Psychology Services of Long Island PLLC

  • Cognitive & Behavioral Psychologist
  • Commack, NY
National Provider Identifier
1144523952
Registry record updated Oct 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cognitive & Behavioral PsychologistTaxonomy code 103TB0200X
License
009143-1 Issued in NY
Legal business name
COGNITIVE-BEHAVIORAL PSYCHOLOGY SERVICES OF LONG ISLAND PLLC
Practice address
2171 Jericho Tpke Ste 250
Commack, NY 11725-2947
Phone
(516) 558-7490
Fax
(877) 205-6740
NPI assigned
Dec 16, 2010
Organization subpart
Yes
Parent organization
COGNITIVE-BEHAVIORAL PSYCHOLOGY SERVICES OF LONG ISLANDAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 28, 2025

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

Authorized official

Name
Michael B Eberlin, PH.D.NPI 1588648919
Title
Psychologist/Owner
Phone
(631) 670-6621

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
Cognitive & Behavioral PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TB0200X 009143-1 NY Primary

Addresses

Primary practice location

2171 Jericho Tpke Ste 250
Commack, NY 11725-2947

Mailing address

2171 Jericho Tpke Ste 250
Commack, NY 11725-2947
Phone (516) 558-7490

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120327000636 NY Part B Supplier - Clinic/Group Practice 1052571114 Receives reassigned benefits from 2 practitioners
Practice locations: Commack, NY

National Provider Directory

National Provider Directory
Tax ID family
Cognitive-Behavioral Psychology Services of Long Island PLLC2 organizations share this tax ID, including this one
Part of
Cognitive-Behavioral Psychology Services of Long Island PLLC

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

649 39th St
Ste 133
Brooklyn, NY 11232
Phone (516) 558-7490

140 Adams Ave
Ste B10
Hauppauge, NY 11788
Phone (516) 558-7490

71 W Main St
Ste 1
Oyster Bay, NY 11771
Phone (516) 558-7490

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 6

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": "1292457600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1761609600000",
    "number": "1144523952",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2171 JERICHO TPKE STE 250",
            "city": "COMMACK",
            "state": "NY",
            "postal_code": "117252947",
            "telephone_number": "516-558-7490",
            "fax_number": "877-205-6740"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2171 JERICHO TPKE STE 250",
            "city": "COMMACK",
            "state": "NY",
            "postal_code": "117252947",
            "telephone_number": "516-558-7490",
            "fax_number": "877-205-6740"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COGNITIVE-BEHAVIORAL PSYCHOLOGY SERVICES OF LONG ISLAND PLLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "COGNITIVE-BEHAVIORAL PSYCHOLOGY SERVICES OF LONG ISLAND",
        "enumeration_date": "2010-12-16",
        "last_updated": "2025-10-28",
        "certification_date": "2025-10-28",
        "status": "A",
        "authorized_official_last_name": "EBERLIN",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "PSYCHOLOGIST/OWNER",
        "authorized_official_telephone_number": "631-670-6621",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103TB0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Cognitive & Behavioral",
            "state": "NY",
            "license": "009143-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Commack, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.