Organization Active NPI

Ilene Jurmann, PH.D., Psychologist, P.C.

Doing business as Complete Psychological Services

  • Clinical Psychologist
  • Amityville, NY
National Provider Identifier
1346556867
Registry record updated Aug 21, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
013920 Issued in NY
Legal business name
ILENE JURMANN, PH.D., PSYCHOLOGIST, P.C.
Doing business as
Complete Psychological Services
Practice address
5 Dowsing PL
Amityville, NY 11701-3719
Phone
(631) 598-0147
NPI assigned
Aug 21, 2010
Last updated
Aug 21, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 21, 2010

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

Authorized official

Name
Dr. Ilene Jurmann, PH.D.NPI 1700986288
Title
President
Phone
(516) 641-4961

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
Clinical PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103TC0700X 013920 NY Primary

Addresses

Primary practice location

5 Dowsing PL
Amityville, NY 11701-3719

Mailing address

51 Ann Dr
Syosset, NY 11791-5906
Phone (516) 641-4961

Other names 1

  • Complete Psychological Services Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110103000695 NY Part B Supplier - Clinic/Group Practice 4688862824 Receives reassigned benefits from 1 practitioner
Practice locations: Smithtown, NY

National Provider Directory

National Provider Directory

Locations

5 Dowsing Pl
Amityville, NY 11701
Phone (631) 598-0147

21 Redwood Ln
Smithtown, NY 11787
Phone (631) 360-3330

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1282348800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1282348800000",
    "number": "1346556867",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "51 ANN DR",
            "city": "SYOSSET",
            "state": "NY",
            "postal_code": "117915906",
            "telephone_number": "516-641-4961"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 DOWSING PL",
            "city": "AMITYVILLE",
            "state": "NY",
            "postal_code": "117013719",
            "telephone_number": "631-598-0147"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ILENE JURMANN, PH.D., PSYCHOLOGIST, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-08-21",
        "last_updated": "2010-08-21",
        "status": "A",
        "authorized_official_last_name": "JURMANN",
        "authorized_official_first_name": "ILENE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "516-641-4961",
        "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": "013920",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Complete Psychological Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Amityville, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2010; 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.