Healthcare Provider Details

I. General information

NPI: 1235057449
Provider Name (Legal Business Name): NORTH STAR PSYCHOLOGICAL SERVICES PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/07/2026
Last Update Date: 07/07/2026
Certification Date: 07/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1979 E 17TH ST
BROOKLYN NY
11229-3407
US

IV. Provider business mailing address

1979 E 17TH ST
BROOKLYN NY
11229-3407
US

V. Phone/Fax

Practice location:
  • Phone: 347-893-4329
  • Fax:
Mailing address:
  • Phone: 347-893-4329
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number State

VIII. Authorized Official

Name: SUSAN LOTTO
Title or Position: PARTNER
Credential:
Phone: 917-407-0460