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Organization
PORT JEFFERSON PSYCHOLOGICAL & VOCATIONAL P.C.
Active
Organization
PORT JEFFERSON PSYCHOLOGICAL & VOCATIONAL P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SARAH C LONG PSY.D. (OWNER)
(631) 928-4635
Entity
Organization
Contact information
Practice address
5225-46 ROUTE 347, PORT JEFFERSON STATION, NY 11776-2060
(631) 928-4635
(631) 928-4784
Mailing address
5225-46 ROUTE 347, PORT JEFFERSON STATION, NY 11776-2060
(631) 928-4635
(631) 928-4784
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
—
—
103TC2200X
Clinical Child & Adolescent Psychologist
—
—
1041C0700X
Clinical Social Worker
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02416457
—
NY
01
—
144865
VALUE OPTIONS
—
01
—
211135000
MAGELLAN
—
01
—
7333181002
GHI
—
Enumeration date
08/30/2006
Last updated
02/22/2017
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