Active NPI
Mbberenberg Psychological Services, P.C.
- Psychologist
- Brooklyn, NY
National Provider Identifier
1356482343
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 005885
- Legal business name
- MBBERENBERG PSYCHOLOGICAL SERVICES, P.C.
- Practice address
- 482 2ND St
Suite #1
Brooklyn, NY 11215-2503 - Phone
- (718) 768-2461
- Fax
- (718) 768-2461
- NPI assigned
- Feb 11, 2007
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Martin Berenberg
- Title
- President
- Phone
- (718) 768-2461
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | 005885 | NY | Primary |
Addresses
Primary practice location
482 2ND St
Suite #1
Brooklyn, NY 11215-2503
Mailing address
86 Prospect Park W
Brooklyn, NY 11215-3575
Phone (718) 768-2461
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 056183 | Other | NY | VALUEOPTIONS PROVIDER ID |
| 6804058 | Other | NY | GHI PROVIDER ID |
| P2047617 | Other | NY | OXFORD INS.CO.PROVIDER ID |
| 0911717 | Other | NY | AETNA PROVIDER ID |
National Provider Directory
National Provider DirectoryLocations
40 Middle Neck Rd
Ste D
Great Neck, NY 11021
Phone (516) 466-5076
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1171152000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1598054400000",
"number": "1356482343",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "86 PROSPECT PARK W",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112153575",
"telephone_number": "718-768-2461",
"fax_number": "718-768-2461"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "482 2ND ST",
"address_2": "SUITE #1",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112152503",
"telephone_number": "718-768-2461",
"fax_number": "718-768-2461"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "MBBERENBERG PSYCHOLOGICAL SERVICES, P.C.",
"organizational_subpart": "NO",
"enumeration_date": "2007-02-11",
"last_updated": "2020-08-22",
"status": "A",
"authorized_official_last_name": "BERENBERG",
"authorized_official_first_name": "MARTIN",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "718-768-2461",
"authorized_official_name_prefix": "Dr."
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Psychologist",
"state": "NY",
"license": "005885",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "VALUEOPTIONS PROVIDER ID",
"identifier": "056183",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "GHI PROVIDER ID",
"identifier": "6804058",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "OXFORD INS.CO.PROVIDER ID",
"identifier": "P2047617",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA PROVIDER ID",
"identifier": "0911717",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Brooklyn, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.