Robert Michael Ibraham, JD, PHD, CASAC-M/G

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

028005-01 Issued in NY

Practice address

220 Veterans Memorial Hwy
Hauppauge, NY 11788-2420

Phone

(631) 406-5518

NPI assigned

Sep 20, 2018

Last updated

May 13, 2026By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Juris Doctor, Doctor of Philosophy

State licenses

Practice roles

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.

• Coordinated Behavioral Care Ipa Inc

  • Multi-Specialty Clinic/Center
  • Bronx, NY
  • NPI 1457881443
  NPD (past)
• Samaritan Daytop Village, Inc.

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Huntington Station, NY
  • NPI 1831210038
  NPD (past)

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

{
    "created_epoch": "1537401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1778630400000",
    "number": "1932683323",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18 TROUT ST",
            "city": "OAKDALE",
            "state": "NY",
            "postal_code": "117691529",
            "telephone_number": "631-589-9500",
            "fax_number": "631-647-3130"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "220 VETERANS MEMORIAL HWY",
            "city": "HAUPPAUGE",
            "state": "NY",
            "postal_code": "117882420",
            "telephone_number": "631-406-5518"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IBRAHAM",
        "first_name": "ROBERT",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "JD, PHD, CASAC-M/G",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-09-20",
        "last_updated": "2026-05-13",
        "certification_date": "2026-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NY",
            "license": "34794",
            "primary": false
        },
        {
            "code": "103TA0400X",
            "taxonomy_group": "",
            "desc": "Psychologist, Addiction (Substance Use Disorder)",
            "state": "NY",
            "license": "028005-01",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "028005-01",
            "primary": true
        },
        {
            "code": "103TP2701X",
            "taxonomy_group": "",
            "desc": "Psychologist, Group Psychotherapy",
            "state": "NY",
            "license": "028005-01",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Linda Hyman
• Theresa Iacopelli, OTR/L
• Michele Iallonardi, M.S. ED
• Jaime Iamunno, LMT, RN, BSN
• Sandra Iasevoli
• Shaheda Ahmed Iftikhar, MD
• Yelena Iglanova, MD
• Gianna Ilacqua
• Noel Im, CNIM
• Ime Med

• Clinical Psychologist in Hauppauge, NY
• Providers in Hauppauge, 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 May 13, 2026; 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.