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General NPI Number Information
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NPI Number | 1972217339
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Entity Type | Organization
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Legal Business Name | DR LESSANS PSYCHOLOGY PC
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Dates
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Enumeration Date | 01/10/2023
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Last Update Date | 01/10/2023
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Provider Practice Location Address
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Address Line | 1025 NORTHERN BLVD. SUITE 95
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City | ROSLYN
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State | NY
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Zip | 11576
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Country | US
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Telephone | 516-996-3310
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Fax |
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Provider Business Mailing Address
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Address Line | 1 HILLDALE LN
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City | SANDS POINT
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State | NY
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Zip | 11050
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Country | US
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Telephone | 516-996-3310
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. STACEY LESSANS
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Credential | PSY.D.
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Telephone | 516-996-3310
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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 |
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License Number State |
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