Healthcare Provider Details

I. General information

NPI: 1689872608
Provider Name (Legal Business Name): NEW BEGINNINGS PSYCHOLOGY, LLC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/11/2007
Last Update Date: 06/16/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

775 PARK AVE SUITE 356
HUNTINGTON NY
11743-3976
US

IV. Provider business mailing address

775 PARK AVE SUITE 356
HUNTINGTON NY
11743-3976
US

V. Phone/Fax

Practice location:
  • Phone: 631-784-7761
  • Fax: 631-784-7831
Mailing address:
  • Phone: 631-784-7761
  • Fax: 631-784-7831

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number013873-1
License Number StateNY

VIII. Authorized Official

Name: RISA LEVENSON
Title or Position: DIRECTOR
Credential: PH.D.
Phone: 631-784-7761