# CHILD PSYCHOLOGY OF LONG ISLAND

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1003480799
- **Authorized official:** JACALYN BRUNO PSY.D. (PSYCHOLOGIST)
- **Authorized official phone:** (631) 806-6889

## Contact information

- **Practice address:** 55 WEEKS ST, BLUE POINT, NY 11715-1516
- **Practice address phone:** (631) 806-6889
- **Mailing address:** 55 WEEKS ST, BLUE POINT, NY 11715-1516
- **Mailing address phone:** (631) 806-6889

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 103T00000X | Psychologist | — | NULL | — |
| 103T00000X | Psychologist | — | — | — |
| 103TC1900X | Counseling Psychologist | — | NULL | — |
| 103TC1900X | Counseling Psychologist | — | — | — |
| 103TC2200X | Clinical Child & Adolescent Psychologist | — | NULL | Yes |
| 103TC2200X | Clinical Child & Adolescent Psychologist | — | — | Yes |
| 103TS0200X | School Psychologist | — | NULL | — |
| 103TS0200X | School Psychologist | — | — | — |

## Other

- **Enumeration date:** 05/17/2021
- **Last updated:** 05/17/2021