Provider Demographics
NPI:1346611233
Name:MICHELLE CONTI PSYD LLC
Entity Type:Organization
Organization Name:MICHELLE CONTI PSYD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:CONTI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:516-316-8925
Mailing Address - Street 1:2889 DAVIS ST
Mailing Address - Street 2:
Mailing Address - City:OCEANSIDE
Mailing Address - State:NY
Mailing Address - Zip Code:11572-2014
Mailing Address - Country:US
Mailing Address - Phone:516-316-8925
Mailing Address - Fax:
Practice Address - Street 1:2889 DAVIS ST
Practice Address - Street 2:
Practice Address - City:OCEANSIDE
Practice Address - State:NY
Practice Address - Zip Code:11572-2014
Practice Address - Country:US
Practice Address - Phone:516-316-8925
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-10-18
Last Update Date:2015-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health