Healthcare Provider Details

I. General information

NPI: 1497232482
Provider Name (Legal Business Name): LLOYD PSYCHOLOGICAL SERVICES, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/23/2018
Last Update Date: 07/23/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

114 E 90TH ST APT 1A
NEW YORK NY
10128-1543
US

IV. Provider business mailing address

1990 LEXINGTON AVE APT 26E
NEW YORK NY
10035-2918
US

V. Phone/Fax

Practice location:
  • Phone: 212-971-9777
  • Fax: 212-971-9779
Mailing address:
  • Phone: 917-740-9574
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code103G00000X
TaxonomyClinical Neuropsychologist
License Number021247
License Number StateNY
# 3
Primary TaxonomyN
Taxonomy Code103TA0700X
TaxonomyAdult Development & Aging Psychologist
License Number021247
License Number StateNY
# 4
Primary TaxonomyN
Taxonomy Code103TH0004X
TaxonomyHealth Psychologist
License Number021247
License Number StateNY
# 5
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State
# 6
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 7
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number021247
License Number StateNY

VIII. Authorized Official

Name: SCOTT EMERSON LLOYD
Title or Position: CEO/CLINICAL DIRECTOR
Credential: PHD
Phone: 917-740-9574