Comprehensive Psychology Services PLLC
Organization Active NPI Psychologist · Southampton, NY
NPI 1992980148 · NPPES record last updated Apr 26, 2017
Key facts
- NPI
- 1992980148
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Psychologist 103T00000X
- License
- 013842 (NY)
- Legal business name
- COMPREHENSIVE PSYCHOLOGY SERVICES PLLC
- Practice address
- 64 County Road 39
Southampton, NY 11968-5215 - Phone
- (631) 702-1000
- NPI assigned
- Jan 7, 2008
- Organization subpart
- No
Authorized official
- Name
- Dr. Amy Rosen, PSY.D.
- Title
- Sole Member
- Phone
- (631) 708-6041
Practitioners 1
-
Amy Rosen, PSY.D.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NY
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20080320000015 | NY | Part B Supplier - Clinic/Group Practice | 4688750441 |
Receives reassigned benefits from 1 practitioner Practice locations: Center Moriches, NY; South Setauket, NY; Southampton, NY |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist |
103T00000X | 013842 | NY | Yes |
Addresses
Primary practice location
64 County Road 39
Southampton, NY 11968-5215
Mailing address
31 NW Landing Rd
East Hampton, NY 11937-5122
Phone (631) 708-6041
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 02949668 | Medicaid | NY |
Other providers in Southampton, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 26, 2017. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.