Provider Demographics
NPI: | 1871972596 |
---|---|
Name: | HEALTH PSYCHOLOGY ASSOCIATES |
Entity type: | Organization |
Organization Name: | HEALTH PSYCHOLOGY ASSOCIATES |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | DIRECTOR/OWNER |
Authorized Official - Prefix: | DR |
Authorized Official - First Name: | JULIE |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | MORISON |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | PHD |
Authorized Official - Phone: | 518-210-1188 |
Mailing Address - Street 1: | 260 WASHINGTON AVENUE EXT |
Mailing Address - Street 2: | |
Mailing Address - City: | ALBANY |
Mailing Address - State: | NY |
Mailing Address - Zip Code: | 12203-6326 |
Mailing Address - Country: | US |
Mailing Address - Phone: | |
Mailing Address - Fax: | |
Practice Address - Street 1: | 260 WASHINGTON AVENUE EXT |
Practice Address - Street 2: | |
Practice Address - City: | ALBANY |
Practice Address - State: | NY |
Practice Address - Zip Code: | 12203-6326 |
Practice Address - Country: | US |
Practice Address - Phone: | 518-210-1188 |
Practice Address - Fax: | |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2015-05-27 |
Last Update Date: | 2015-05-27 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
NY | 021134 | 103T00000X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 103T00000X | Behavioral Health & Social Service Providers | Psychologist | Group - Multi-Specialty |