Healthcare Provider Details

I. General information

NPI: 1952096836
Provider Name (Legal Business Name): THALASSA PSYCHOLOGICAL SERVICES, P.L.L.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/07/2023
Last Update Date: 04/16/2024
Certification Date: 04/16/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

245 N BROADWAY STE 208
SLEEPY HOLLOW NY
10591-2899
US

IV. Provider business mailing address

245 N BROADWAY STE 208
SLEEPY HOLLOW NY
10591-2899
US

V. Phone/Fax

Practice location:
  • Phone: 914-488-6432
  • Fax:
Mailing address:
  • Phone: 914-488-6432
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code221700000X
TaxonomyArt Therapist
License Number
License Number State

VIII. Authorized Official

Name: DR. ALEXANDRA ELECTRIS
Title or Position: CO-FOUNDER AND SENIOR PSYCHOLOGIST
Credential: PHD, LCAT
Phone: 917-969-8118