Organization
FIVE HARBORS PSYCHOLOGY, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JENNIFER KORNREICH PH.D. (CLINICAL PSYCHOLOGIST/DIRECTOR)
(631) 424-4600
Entity
Organization
Contact information
Practice address
23 GREEN ST, SUITE 203, HUNTINGTON, NY 11743-3336
(631) 424-4600
Mailing address
23 GREEN ST, SUITE 203, HUNTINGTON, NY 11743-3336
(631) 424-4600
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
018847
NY
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
018847
NY
Other
Enumeration date
01/05/2014
Last updated
01/07/2014
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