Organization
AWARENESS PSYCHOLOGICAL HEALTH AND GROWTH SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RIVCKA EDELSTEIN PHD (DIRECTOR)
(617) 429-8049
Entity
Organization
Contact information
Practice address
1394 STONY BROOK RD, STONY BROOK, NY 11790-2205
(617) 429-8049
Mailing address
125 PLEASANT ST APT 609, BROOKLINE, MA 02446-7183
(617) 277-1961
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
8090-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
058472
VALUE OPTIONS
NY
01
—
81182000
MAGELLAN BEHAVIORAL HEALT
NY
01
—
V5332
EMPIRE BLUE CROSS
NY
Enumeration date
04/17/2007
Last updated
08/22/2020
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