Organization
ADULT CARE PSYCHOLOGY SERVICES, PLLC
Active
Other names
Adult Care Services
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARK KUTNER PH.D. (EXECUTIVE DIRECTOR)
(718) 575-3510
Entity
Organization
Contact information
Practice address
13711 73RD TER, FLUSHING, NY 11367-2303
(718) 575-3510
(718) 575-0391
Mailing address
13711 73RD TER, FLUSHING, NY 11367-2303
(718) 575-3510
(718) 575-0391
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000409099
UNITED BEHAVIORAL HEALTH
—
05
—
02164212
—
NY
01
—
403672
EMBLEM HEALTH
—
01
—
678886
VALUE OPTIONS
—
01
—
7379731
AETNA
NY
01
—
814181000
MAGELLAN
NY
Enumeration date
12/07/2006
Last updated
05/23/2012
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