| NPI | 1316597008 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JACOB JACOBY CEO 845-697-0000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC2200X Psychologist, Clinical Child & Adolescent |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| 103TB0200X Psychologist, Cognitive & Behavioral | |
| 103TF0000X Psychologist, Family | |
| Enumeration Date | 2019-09-16 |
| Last Update Date | 2019-09-16 |