Healthcare Provider Details

I. General information

NPI: 1285967992
Provider Name (Legal Business Name): CYPHER PSYCHOLOGICAL SERVICES, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/13/2009
Last Update Date: 09/13/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

160 ALLENS CREEK RD
ROCHESTER NY
14618-3309
US

IV. Provider business mailing address

142 CANTERBURY RD
ROCHESTER NY
14607-3432
US

V. Phone/Fax

Practice location:
  • Phone: 585-233-5591
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number016330
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code103TE1100X
TaxonomyExercise & Sports Psychologist
License Number016330
License Number StateNY
# 3
Primary TaxonomyY
Taxonomy Code103TC2200X
TaxonomyClinical Child & Adolescent Psychologist
License Number016330
License Number StateNY

VIII. Authorized Official

Name: DR. CRAIG WILLIAM CYPHER
Title or Position: PRESIDENT
Credential: PSY.D.
Phone: 585-233-5591