Active NPI
Rebecca Hoffenberg, MA
- Psychologist
- Long Beach, NY
National Provider Identifier
1841691623
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- P09316
- Practice address
- Long Beach Reach
2-12 W Park Ave
Long Beach, NY 11561 - Phone
- (516) 318-5736
- NPI assigned
- Sep 11, 2014
- Last updated
- Feb 28, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | |||
| Clinical Psychologist | 103TC0700X | 023704 | NY | |
| Psychologist | 103T00000X | P09316 | NY | Primary |
Addresses
Primary practice location
Long Beach Reach
2-12 W Park Ave
Long Beach, NY 11561
Mailing address
2-12 W Park Ave
Long Beach, NY 11561-2025
Other practice location 1
156 W 56th St Ste 1804
New York, NY 10019-3878
Phone (212) 851-8100
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 023704 | Other | NY | LICENSE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Jun 30, 2020 through Jun 30, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| P09316 | NY | MD | Psychologist |
| 023704 | NY | MD | Clinical Psychologist |
| 023074 | NY | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1410393600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1551312000000",
"number": "1841691623",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2-12 W PARK AVE",
"city": "LONG BEACH",
"state": "NY",
"postal_code": "115612025"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "LONG BEACH REACH",
"address_2": "2-12 W PARK AVE",
"city": "LONG BEACH",
"state": "NY",
"postal_code": "11561",
"telephone_number": "516-318-5736"
}
],
"practiceLocations": [
{
"address_1": "156 W 56th St Ste 1804",
"address_purpose": "LOCATION",
"city": "New York",
"state": "NY",
"postal_code": "100193878",
"country_code": "US",
"telephone_number": "212-851-8100",
"fax_number": "212-537-0102",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "HOFFENBERG",
"first_name": "REBECCA",
"credential": "MA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-09-11",
"last_updated": "2019-02-28",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": null,
"license": null,
"primary": false
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "NY",
"license": "023704",
"primary": false
},
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "NY",
"license": "P09316",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSE",
"identifier": "023704",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Long Beach, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.