Consumer Psychological Services PC

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

011044 Issued in NY

Legal business name

CONSUMER PSYCHOLOGICAL SERVICES PC

Practice address

55 Old Nyack Tpke
Suite 601
Nanuet, NY 10954-2461

Phone

(914) 714-5023

Fax

(845) 634-0806

NPI assigned

Nov 2, 2010

Organization subpart

No

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

Authorized official

Name

Dr. Larry S. Borakove, PH.D.

Title

President

Phone

(914) 714-5023

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1288656000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1288656000000",
    "number": "1194025445",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "75 ZUKOR RD",
            "city": "NEW CITY",
            "state": "NY",
            "postal_code": "109565507",
            "telephone_number": "914-714-5023",
            "fax_number": "845-634-0806"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 OLD NYACK TPKE",
            "address_2": "SUITE 601",
            "city": "NANUET",
            "state": "NY",
            "postal_code": "109542461",
            "telephone_number": "914-714-5023",
            "fax_number": "845-634-0806"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CONSUMER PSYCHOLOGICAL SERVICES PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-11-02",
        "last_updated": "2010-11-02",
        "status": "A",
        "authorized_official_last_name": "BORAKOVE",
        "authorized_official_first_name": "LARRY",
        "authorized_official_middle_name": "S.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "914-714-5023",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "011044",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02192671",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Clinical Psychologist in Nanuet, NY
• Providers in Nanuet, NY by specialty
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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2010; 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.