Stephanie Ann Perez, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

012191 Issued in NY

Practice address

73 Port Watson St
Cortland, NY 13045-3027

Phone

(607) 753-6511

Fax

(607) 753-1648

NPI assigned

May 6, 2007

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in NY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Che Senior Psychological Services, PC

  • Clinical Psychologist
  • Brooklyn, NY
  • NPI 1023078219
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1178409600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1003028341",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "73 PORT WATSON ST",
            "city": "CORTLAND",
            "state": "NY",
            "postal_code": "130453027",
            "telephone_number": "607-753-6511",
            "fax_number": "607-753-1648"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "73 PORT WATSON ST",
            "city": "CORTLAND",
            "state": "NY",
            "postal_code": "130453027",
            "telephone_number": "607-753-6511",
            "fax_number": "607-753-1648"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEREZ",
        "first_name": "STEPHANIE",
        "middle_name": "ANN",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-06",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "012191",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VALUE OPTIONS NUMBER",
            "identifier": "246-683",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WCB AUTH #",
            "identifier": "S12191-3",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VALUE OPTIONS GHI PIN NUM",
            "identifier": "688-5837",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIDELIS",
            "identifier": "040728-000-060",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Erika Moran Paschal, PA-C
• Isabel Passaro, OTR/L
• Darshan Patel, MD
• Leslie Anne Patriarco, LMSW
• James Paul Pemberton, MD
• Mary Anne Peterson, LCSW-R
• Rebecca Petrie, LMSW
• Laura Pforter
• Kathleen Elizabeth Phalen, RN
• Quoc Van Anh Pham

• Clinical Psychologist in Cortland, NY
• Providers in Cortland, NY by specialty
• Clinical Psychologist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.