Provider Demographics
NPI:1285768978
Name:LONG BEACH PSYCHOLOGICAL ASSOCIATES LLP
Entity type:Organization
Organization Name:LONG BEACH PSYCHOLOGICAL ASSOCIATES LLP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:MAURICE
Authorized Official - Middle Name:
Authorized Official - Last Name:LEVY
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:516-431-0453
Mailing Address - Street 1:32 BAY ST
Mailing Address - Street 2:
Mailing Address - City:EAST ATLANTIC BEACH
Mailing Address - State:NY
Mailing Address - Zip Code:11561-1002
Mailing Address - Country:US
Mailing Address - Phone:516-431-0453
Mailing Address - Fax:
Practice Address - Street 1:2-12 EAST PARK AVE
Practice Address - Street 2:2ND FLOOR- SOMATIC WELLNESS
Practice Address - City:LONG BEACH
Practice Address - State:NY
Practice Address - Zip Code:11561
Practice Address - Country:US
Practice Address - Phone:516-431-0453
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty