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General NPI Number Information
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NPI Number | 1225159122
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Entity Type | Organization
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Legal Business Name | PSYCHOTHERAPY ASSOCIATES
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Dates
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Enumeration Date | 04/02/2007
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 4232 ALBANY POST RD
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City | HYDE PARK
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State | NY
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Zip | 12538-1766
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Country | US
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Telephone | 845-229-6585
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 719
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City | PLEASANT VALLEY
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State | NY
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Zip | 12569-0719
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Country | US
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Telephone | 845-229-6585
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Fax |
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Authorized Official
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Title or Position | PSYCHOLOGIST
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Name | DR. ROGER J. TUMBARELLO
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Credential | PH.D.
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Telephone | 845-229-6585
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 6118
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 364SP0809X
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Taxonomy Name | Adult Psychiatric/Mental Health Clinical Nurse Specialist
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License Number | 325593
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License Number State | NY
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