Provider Demographics
NPI: | 1932427499 |
---|---|
Name: | COMPREHENSIVE CONSULTATION PSYCHOLOGICAL SERVICES, P.C. |
Entity Type: | Organization |
Organization Name: | COMPREHENSIVE CONSULTATION PSYCHOLOGICAL SERVICES, P.C. |
Other - Org Name: | COMPREHENSIVE CONSULTATION |
Other - Org Type: | Doing Business As |
Authorized Official - Title/Position: | DIRECTOR |
Authorized Official - Prefix: | DR |
Authorized Official - First Name: | SANAM |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | HAFEEZ |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | PSYD |
Authorized Official - Phone: | 718-441-0166 |
Mailing Address - Street 1: | 8460 123RD ST |
Mailing Address - Street 2: | |
Mailing Address - City: | KEW GARDENS |
Mailing Address - State: | NY |
Mailing Address - Zip Code: | 11415-3305 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 718-441-0166 |
Mailing Address - Fax: | 718-805-2054 |
Practice Address - Street 1: | 8460 123RD ST |
Practice Address - Street 2: | |
Practice Address - City: | KEW GARDENS |
Practice Address - State: | NY |
Practice Address - Zip Code: | 11415-3305 |
Practice Address - Country: | US |
Practice Address - Phone: | 718-441-0166 |
Practice Address - Fax: | 718-805-2054 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2010-05-08 |
Last Update Date: | 2010-05-08 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
101YM0800X, 104100000X, 1041S0200X, 2084N0402X, 2084P0804X, 235Z00000X | ||
NY | 68-016117 | 103G00000X, 103T00000X, 103TC2200X, 103TF0200X, 103TM1800X, 103TS0200X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 103G00000X | Behavioral Health & Social Service Providers | Clinical Neuropsychologist | Group - Multi-Specialty | |
No | 101YM0800X | Behavioral Health & Social Service Providers | Counselor | Mental Health | Group - Multi-Specialty |
No | 103T00000X | Behavioral Health & Social Service Providers | Psychologist | Group - Multi-Specialty | |
No | 103TC2200X | Behavioral Health & Social Service Providers | Psychologist | Clinical Child & Adolescent | Group - Multi-Specialty |
No | 103TF0200X | Behavioral Health & Social Service Providers | Psychologist | Forensic | Group - Multi-Specialty |
No | 103TM1800X | Behavioral Health & Social Service Providers | Psychologist | Intellectual & Developmental Disabilities | Group - Multi-Specialty |
No | 103TS0200X | Behavioral Health & Social Service Providers | Psychologist | School | Group - Multi-Specialty |
No | 104100000X | Behavioral Health & Social Service Providers | Social Worker | Group - Multi-Specialty | |
No | 1041S0200X | Behavioral Health & Social Service Providers | Social Worker | School | Group - Multi-Specialty |
No | 2084N0402X | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Neurology with Special Qualifications in Child Neurology | Group - Multi-Specialty |
No | 2084P0804X | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Child & Adolescent Psychiatry | Group - Multi-Specialty |
No | 235Z00000X | Speech, Language and Hearing Service Providers | Speech-Language Pathologist | Group - Multi-Specialty |