Organization
ABRIDGED PSYCHOLOGY, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LAURA BONOMO PH.D. (PSYCHOLOGIST/OWNER)
(516) 798-4070
Entity
Organization
Contact information
Practice address
647 FRANKLIN AVE, SUITE: LL4, GARDEN CITY, NY 11530-5746
(516) 798-4070
Mailing address
205 MINEOLA BLVD, APT. 4F, MINEOLA, NY 11501-2550
(516) 698-8178
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
007280
NY
103TB0200X
Cognitive & Behavioral Psychologist
Primary
011068
NY
103TB0200X
Cognitive & Behavioral Psychologist
021509
NY
103TC0700X
Clinical Psychologist
016588
NY
104100000X
Social Worker
090586
NY
Other
Enumeration date
01/05/2017
Last updated
01/09/2017
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