Stefanie Mary Iwanciw, PSYD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

024406 Issued in NY

Practice address

7559 263Rd St
Glen Oaks, NY 11004-1150

Phone

(718) 470-8060

NPI assigned

Jun 10, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Previously, effective Aug 15, 2022 through Aug 15, 2026

Medicare enrollment (NPD)

Enrolled

Practice roles

Networks

• Healthfirst Medicare Network H9678

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.

• Cognitive Behavioral Associates, LLP

  • Cognitive & Behavioral Psychologist
  • Great Neck, NY
  • NPI 1184896417

  Clinical

  NPD (past)

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

{
    "created_epoch": "1623283200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626220800000",
    "number": "1003484635",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7559 263RD ST",
            "city": "GLEN OAKS",
            "state": "NY",
            "postal_code": "110041150"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7559 263RD ST",
            "city": "GLEN OAKS",
            "state": "NY",
            "postal_code": "110041150",
            "telephone_number": "718-470-8060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IWANCIW",
        "first_name": "STEFANIE",
        "middle_name": "MARY",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-10",
        "last_updated": "2021-07-14",
        "certification_date": "2021-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "024406",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Frances Iasso, LCSW
• Pamela Ierardi, DC
• Uzoma Ikwuakar
• M.Hasan Imam
• Aateqa Ismail, M.D.
• Sharat Parameswaran Iyer, M.D., M.S.
• Rachle H Jacobson, LMSW
• Sari H Jacoby, M.D.
• Judith Jaeger, PHD
• Sharwat Jahan, MD

• Clinical Psychologist in Glen Oaks, NY
• Providers in Glen Oaks, 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 14, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.