Jonathan Miljus, PH.D.

Individual provider Active NPI Clinical Psychologist · Brooklyn, NY

NPI 1740542166 · NPPES record last updated Dec 19, 2012

Key facts

NPI
1740542166
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Psychologist 103TC0700X
License
018958 (NY)
Practice address
681 Clarkson Ave
Brooklyn, NY 11203-2125
Phone
(718) 221-7555
NPI assigned
Jun 12, 2012
Sex
Male
Sole proprietor
Yes

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 and National Provider Directory roles.

Medicare Care Compare profile

Specialty
Clinical Psychologist
Education
Other, 2009
Medicare assignment
May accept Medicare assignment
Group practices
Kelly E Bunt LCSW PC (5 clinicians)

Practice addresses (Care Compare)

21 Davis Ave
Stop 2
Poughkeepsie, NY 12603-2649
Phone (845) 867-4926

Medicare participation

Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20120725000867 NY Practitioner - Clinical Psychologist 3779749320 Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
018958NYMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Kelly E Bunt LCSW PC Current
since Sep 1, 2024
Accepting new patients
Connecting the Dots Hudson Valley Youth & Family Services Inc. Past
since Sep 1, 2024
Accepting new patients
Yorkville Psychiatry PLLC Past Accepting new patients

Locations

80 Washington St
Ste 305
Poughkeepsie, NY 12601
Phone (845) 867-4926

21 Davis Ave
Stop 2
Poughkeepsie, NY 12603
Phone (845) 867-4926

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 018958 NY Yes

Addresses

Primary practice location

681 Clarkson Ave
Brooklyn, NY 11203-2125

Mailing address

681 Clarkson Ave
Brooklyn, NY 11203-2125
Phone (718) 221-7555

Other providers in Brooklyn, NY

All providers in Brooklyn, NY · Clinical Psychologist in New York

Sources for this page

Verify at the official NPI Registry.