First Light Psychological Services, P.L.L.C.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

68-60276 Issued in NY

Legal business name

FIRST LIGHT PSYCHOLOGICAL SERVICES, P.L.L.C.

Practice address

1111 Broadhollow Rd
Suite 204
Farmingdale, NY 11735-4820

Phone

(631) 414-7181

Fax

(631) 414-7178

NPI assigned

Dec 5, 2006

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Theresa Irene Desantis, PH.D.NPI 1194883884

Title

President

Phone

(631) 414-7181

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Theresa Irene Desantis, PH.D.

  • Clinical Psychologist
  • Farmingdale, NY
  • NPI 1194883884
  Medicare reassignment Authorized official
• Catherine Hackett, LMHC

  • Mental Health Counselor
  • Garden City, NY
  • NPI 1831848548
  NPD (past)
• Chydavi Singh, LCSW

  • Clinical Social Worker
  • Brooklyn, NY
  • NPI 1417606021
  NPD (past)

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

{
    "created_epoch": "1165276800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1922166628",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "32 SALLY LN",
            "city": "PLAINVIEW",
            "state": "NY",
            "postal_code": "118031434",
            "telephone_number": "516-637-0689",
            "fax_number": "631-414-7178"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 BROADHOLLOW RD",
            "address_2": "SUITE 204",
            "city": "FARMINGDALE",
            "state": "NY",
            "postal_code": "117354820",
            "telephone_number": "631-414-7181",
            "fax_number": "631-414-7178"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FIRST LIGHT PSYCHOLOGICAL SERVICES, P.L.L.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-05",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "DESANTIS",
        "authorized_official_first_name": "THERESA",
        "authorized_official_middle_name": "IRENE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "631-414-7181",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "68-60276",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Angela M Ferrari, D.D.S.
• Kevin Ferry
• Fiber Foot Appliances Inc (Fiber Lab)
• Fiber Foot Appliances, Inc.
• Nancy Lee Fili
• Andrew P Fishenfeld
• Lauren Fisher, M.S.
• Lindsey Anne Fisher
• Wallenstein Fleury
• Eric David Folino, R.PH

• Clinical Psychologist in Farmingdale, NY
• Providers in Farmingdale, NY by specialty
• Clinical Psychologist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.