Individual
DR. BECCA ILVENTO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSY.D.
Contact information
Practice address
200 BELLE TERRE RD, PSYCHOLOGY DEPT, PORT JEFFERSON, NY 11777
(631) 474-6308
Mailing address
200 BELLE TERRE RD, PSYCHOLOGY DEPT, PORT JEFFERSON, NY 11777
(631) 474-6308
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
024899-01
NY
Other
Enumeration date
12/09/2019
Last updated
04/03/2025
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