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General NPI Number Information
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NPI Number | 1861696817
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Entity Type | Organization
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Legal Business Name | COGNITIVE-BEHAVIORAL PSYCHOLOGY SERVICES OF LONG ISLAND
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Dates
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Enumeration Date | 06/13/2007
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Last Update Date | 10/28/2025
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Provider Practice Location Address
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Address Line | 2171 JERICHO TPKE STE 250
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City | COMMACK
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State | NY
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Zip | 11725-2947
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Country | US
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Telephone | 516-558-7490
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Fax | 877-205-6740
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Provider Business Mailing Address
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Address Line | 2171 JERICHO TPKE STE 250
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City | COMMACK
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State | NY
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Zip | 11725-2947
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Country | US
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Telephone | 516-558-7490
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Fax | 877-205-6740
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Authorized Official
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Title or Position | DIRECTOR & MANAGING MEMBER
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Name | DR. MICHAEL BARRY EBERLIN
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Credential | PH.D.
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Telephone | 516-558-7490
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 009143-1
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License Number State | NY
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