Healthcare Provider Details

I. General information

NPI: 1609364801
Provider Name (Legal Business Name): VECCHIONE PSYCHOLOGICAL SERVICES, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/24/2018
Last Update Date: 12/16/2024
Certification Date: 12/16/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9 BARBARA CT
GREENLAWN NY
11740-1103
US

IV. Provider business mailing address

9 BARBARA CT
GREENLAWN NY
11740-1103
US

V. Phone/Fax

Practice location:
  • Phone: 631-385-2370
  • Fax:
Mailing address:
  • Phone: 631-385-2370
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number010380-1
License Number StateNY

VIII. Authorized Official

Name: DR. CARLA JO VECCHIONE
Title or Position: PSYCHOLOGIST
Credential: PH.D.
Phone: 631-385-2370