Provider Demographics
NPI:1447454913
Name:ASH PSYCHOLOGICAL SERVICES LLC
Entity type:Organization
Organization Name:ASH PSYCHOLOGICAL SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:EVA
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:ASH
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:631-327-0115
Mailing Address - Street 1:44 ELM ST STE 8
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON
Mailing Address - State:NY
Mailing Address - Zip Code:11743-3403
Mailing Address - Country:US
Mailing Address - Phone:631-327-0115
Mailing Address - Fax:
Practice Address - Street 1:44 ELM ST STE 8
Practice Address - Street 2:
Practice Address - City:HUNTINGTON
Practice Address - State:NY
Practice Address - Zip Code:11743-3403
Practice Address - Country:US
Practice Address - Phone:631-327-0115
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-11
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY014215103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty