Commack Consultation Center

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

008998 Issued in NY

Legal business name

COMMACK CONSULTATION CENTER

Practice address

66 Harned Rd
Commack, NY 11725-3527

Phone

16315438577

NPI assigned

Jul 14, 2017

Organization subpart

No

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

Authorized official

Name

Carol Ann Kaufman, MA

Title

Owner/Manager

Phone

(631) 543-8577

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1499990400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1499990400000",
    "number": "1245752971",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "66 HARNED RD",
            "city": "COMMACK",
            "state": "NY",
            "postal_code": "117253527",
            "telephone_number": "16315438577"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "66 HARNED RD",
            "city": "COMMACK",
            "state": "NY",
            "postal_code": "117253527",
            "telephone_number": "16315438577"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMACK CONSULTATION CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-07-14",
        "last_updated": "2017-07-14",
        "status": "A",
        "authorized_official_last_name": "KAUFMAN",
        "authorized_official_first_name": "CAROL",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "OWNER/MANAGER",
        "authorized_official_telephone_number": "631-543-8577",
        "authorized_official_credential": "MA"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "008998",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Psychologist in Commack, NY
• Providers in Commack, NY by specialty
• Clinical Psychologist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2017; 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.