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General NPI Number Information
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NPI Number | 1750775763
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Entity Type | Organization
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Legal Business Name | COLUMBUS CIRCLE PSYCHOLOGY SERVICES, PLLC
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Dates
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Enumeration Date | 03/27/2015
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Last Update Date | 03/27/2015
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Provider Practice Location Address
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Address Line | 25 CENTRAL PARK W SUITE 1-U
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City | NEW YORK
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State | NY
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Zip | 10023-7253
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Country | US
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Telephone | 917-402-4582
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Fax |
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Provider Business Mailing Address
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Address Line | 875 W 181ST ST 4M
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City | NEW YORK
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State | NY
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Zip | 10033-4468
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Country | US
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Telephone | 212-927-0919
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Fax |
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Authorized Official
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Title or Position | LICENSED CLINICAL PSYCHOLOGIST
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Name | DR. AMY DALEY
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Credential | PH.D.
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Telephone | 917-402-4582
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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 | 020963
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License Number State | NY
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