Individual provider Active NPI

Stephanie F Haag, PSY.D.

  • Cognitive & Behavioral Psychologist
  • Rockville Centre, NY
National Provider Identifier
1790076255
Registry record updated Jun 25, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cognitive & Behavioral PsychologistTaxonomy code 103TB0200X
License
018944-1 Issued in NY
Practice address
165 N Village Ave Ste 112
Rockville Centre, NY 11570-3701
Phone
(516) 665-9669
Fax
(516) 665-9670
NPI assigned
May 2, 2011
Last updated
Jun 25, 2020By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 25, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Cognitive & Behavioral Psychologist 103TB0200X 018944-1 NY Primary
School Psychologist 103TS0200X 018944-1 NY

Addresses

Primary practice location

165 N Village Ave Ste 112
Rockville Centre, NY 11570-3701

Mailing address

400 Montauk Hwy Ste 112
West Islip, NY 11795-4429
Phone (516) 477-0086

Other practice location 1

1926 Oakland Ave
Wantagh, NY 11793-3610
Phone (516) 781-0457

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
018944-1NYMDSchool Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
B&L Cognitive Behavioral Psychology PLLC CurrentSince May 1, 2009 Accepting new patients
Wantagh Psychological Counseling Services PC PastSince Dec 8, 2010 Accepting new patients

Locations

165 N Village Ave
Ste 112
Rockville Centre, NY 11570
Phone (516) 665-9669

165 N Village Ave
Ste 216
Rockville Ctr, NY 11570
Phone (516) 665-9669

400 Montauk Hwy
Ste 112
West Islip, NY 11795
Phone (631) 321-7107

Organizations & group practices 2

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": "1304294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1593043200000",
    "number": "1790076255",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 MONTAUK HWY STE 112",
            "city": "WEST ISLIP",
            "state": "NY",
            "postal_code": "117954429",
            "telephone_number": "516-477-0086"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "165 N VILLAGE AVE STE 112",
            "city": "ROCKVILLE CENTRE",
            "state": "NY",
            "postal_code": "115703701",
            "telephone_number": "516-665-9669",
            "fax_number": "516-665-9670"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1926 Oakland Ave",
            "address_purpose": "LOCATION",
            "city": "Wantagh",
            "state": "NY",
            "postal_code": "117933610",
            "country_code": "US",
            "telephone_number": "516-781-0457",
            "fax_number": "718-470-8131",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HAAG",
        "first_name": "STEPHANIE",
        "middle_name": "F",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-05-02",
        "last_updated": "2020-06-25",
        "certification_date": "2020-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TB0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Cognitive & Behavioral",
            "state": "NY",
            "license": "018944-1",
            "primary": true
        },
        {
            "code": "103TS0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, School",
            "state": "NY",
            "license": "018944-1",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockville Centre, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 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.

Verify at the official NPI Registry.