Healthcare Provider Details

I. General information

NPI: 1942684964
Provider Name (Legal Business Name): PS CONSULTANTS, PSYCHOLOGY & LMSW, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/20/2015
Last Update Date: 07/20/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 WESTVIEW DR
MATTITUCK NY
11952-2951
US

IV. Provider business mailing address

1600 WESTVIEW DR
MATTITUCK NY
11952-2951
US

V. Phone/Fax

Practice location:
  • Phone: 631-987-8337
  • Fax:
Mailing address:
  • Phone: 631-987-8337
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number014586
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number068545
License Number StateNY

VIII. Authorized Official

Name: DR. KARIN SCHLEE
Title or Position: CLINICAL PSYCHOLOGIST
Credential: PH.D.
Phone: 631-987-8337