NPIMap

Organization Active NPI

Wantagh Psychological Counseling Services PC

  • Psychologist
  • Wantagh, NY
National Provider Identifier
1922134253
Registry record updated Apr 25, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
10383 Issued in NY
Legal business name
WANTAGH PSYCHOLOGICAL COUNSELING SERVICES PC
Practice address
1926 Oakland Ave
Wantagh, NY 11793-3610
Phone
(516) 781-0457
Fax
(516) 781-0457
NPI assigned
Feb 23, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 25, 2011

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

Authorized official

Name
Dr. Mark H Perlman, PHDNPI 1457431132
Title
Psychologist
Phone
(516) 781-0457

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103T00000X 10383 NY Primary

Addresses

Primary practice location

1926 Oakland Ave
Wantagh, NY 11793-3610

Mailing address

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

Other identifiers 1

IdentifierTypeStateIssuer
01281929MedicaidNY

Other names 1

  • Wantagh Seaford Counseling Services Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040312000765 NY Part B Supplier - Clinic/Group Practice 9032008545 Receives reassigned benefits from 2 practitioners
Practice locations: Wantagh, NY

National Provider Directory

National Provider Directory

Locations

1926 Oakland Ave
Wantagh, NY 11793
Phone (516) 359-7124

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1172188800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1303689600000",
    "number": "1922134253",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1926 OAKLAND AVE",
            "city": "WANTAGH",
            "state": "NY",
            "postal_code": "117933610",
            "telephone_number": "516-781-0457",
            "fax_number": "516-781-0457"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1926 OAKLAND AVE",
            "city": "WANTAGH",
            "state": "NY",
            "postal_code": "117933610",
            "telephone_number": "516-781-0457",
            "fax_number": "516-781-0457"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WANTAGH PSYCHOLOGICAL COUNSELING SERVICES PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-23",
        "last_updated": "2011-04-25",
        "status": "A",
        "authorized_official_last_name": "PERLMAN",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "PSYCHOLOGIST",
        "authorized_official_telephone_number": "516-781-0457",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist",
            "state": "NY",
            "license": "10383",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01281929",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Wantagh Seaford Counseling Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Wantagh, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.