Moss, Keith Cory

Moss, Keith Cory is an sole proprietor health care provider with primary practice located at 50 Sagamore Dr , Plainview NY 11803-1522. He recently has 10 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Psychologist, Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), Behavioral Health & Social Service Providers / Adult Development & Aging, Behavioral Health & Social Service Providers / Cognitive & Behavioral, Behavioral Health & Social Service Providers / Counseling, Behavioral Health & Social Service Providers / Clinical Child & Adolescent, Behavioral Health & Social Service Providers / Family, Behavioral Health & Social Service Providers / Health Service, Behavioral Health & Social Service Providers / School, Behavioral Health & Social Service Providers / Clinical. Behavioral Health & Social Service Providers / Clinical is his primary health care specialty. Moss, Keith Cory can be contacted via phone (631) 271-8800.

Contact Information

Primary practice address
50 Sagamore Dr Plainview NY 11803-1522
Phone: (631) 271-8800
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Psychologist 103T00000X 8629 New York
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 103TA0400X 8629 New York
Behavioral Health & Social Service Providers / Adult Development & Aging 103TA0700X 8629 New York
Behavioral Health & Social Service Providers / Cognitive & Behavioral 103TB0200X 8629 New York
Behavioral Health & Social Service Providers / Counseling 103TC1900X 8629 New York
Behavioral Health & Social Service Providers / Clinical Child & Adolescent 103TC2200X 8629 New York
Behavioral Health & Social Service Providers / Family 103TF0000X 8629 New York
Behavioral Health & Social Service Providers / Health Service 103TH0100X 8629 New York
Behavioral Health & Social Service Providers / School 103TS0200X 8629 New York
Behavioral Health & Social Service Providers / Clinical 103TC0700X 8629 New York

Profile Details

NPI number 1205806981
LBN Legal business name Moss, Keith Cory
Credentials PH.D.
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jan 25th, 2006
Last updated Mar 6th, 2023 - about last year

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1205806981 NPPES
New York MEDICAID 00972665

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