Individual provider Active NPI

Jacqueline Cara Talesnick, PSY.D.

  • Psychologist
  • Long Beach, NY
National Provider Identifier
1710316351
Registry record updated Feb 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
P87850 Issued in NY
Practice address
2-12 W Park Ave
Suite 200
Long Beach, NY 11561-2025
Phone
(516) 889-2332
Fax
(516) 889-2399
NPI assigned
Nov 4, 2013
Last updated
Feb 25, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 25, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X P87850 NY Primary

Addresses

Primary practice location

2-12 W Park Ave
Suite 200
Long Beach, NY 11561-2025

Mailing address

313 E. Broadway P.O. Box 1126
Glendale, CA 91205-9998
Phone (818) 446-2522

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160104001112 CA Practitioner - Clinical Psychologist 6507168895 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

500 E Olive Ave
Suite 540
Burbank, CA 91501-2132
Phone (818) 446-2238

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
P87850NYMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Rowan Center for Behavioral Medicine, a Psychological Corporation Psychologist CurrentSince Nov 1, 2015 Accepting new patients
Rowan Center for Behavioral Medicine, a Psychological Corporation Psychologist CurrentSince Nov 1, 2015 Accepting new patients
Long Beach Reach Inc. PastSince Oct 15, 2015 Accepting new patients

Locations

500 E Olive Ave
Ste 540
Burbank, CA 91501
Phone (818) 446-2238

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1383523200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1645747200000",
    "number": "1710316351",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "313 E. BROADWAY P.O. BOX 1126",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912059998",
            "telephone_number": "818-446-2522",
            "fax_number": "516-889-2399"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2-12 W PARK AVE",
            "address_2": "SUITE 200",
            "city": "LONG BEACH",
            "state": "NY",
            "postal_code": "115612025",
            "telephone_number": "516-889-2332",
            "fax_number": "516-889-2399"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TALESNICK",
        "first_name": "JACQUELINE",
        "middle_name": "CARA",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-11-04",
        "last_updated": "2022-02-25",
        "certification_date": "2022-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NY",
            "license": "P87850",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Long Beach, NY

Sources for this page

Verify at the official NPI Registry.