Individual provider Active NPI

Nikol Lyn Stancato, PSYD

  • Clinical Psychologist
  • Brooklyn, NY
National Provider Identifier
1013281674
Registry record updated Nov 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
019499-1 Issued in NY
Practice address
475 Clermont Ave Apt 505
Brooklyn, NY 11238-5969
Phone
(708) 906-9437
NPI assigned
Feb 29, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 28, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 019499-1 NY Primary

Addresses

Primary practice location

475 Clermont Ave Apt 505
Brooklyn, NY 11238-5969

Mailing address

475 Clermont Ave Apt 505
Brooklyn, NY 11238-5969
Phone (708) 906-9437

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL Headway

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20120314000060 NY Practitioner - Clinical Psychologist 8729247564 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
019499-1NYMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Knapp Street Psychiatry, PC Clinical PastSince Feb 2, 2020 Accepting new patients
Che Senior Psychological Services, PC Clinical PastSince Feb 2, 2020 Accepting new patients

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1330473600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1669593600000",
    "number": "1013281674",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "475 CLERMONT AVE APT 505",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112385969",
            "telephone_number": "708-906-9437"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "475 CLERMONT AVE APT 505",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112385969",
            "telephone_number": "708-906-9437"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STANCATO",
        "first_name": "NIKOL",
        "middle_name": "LYN",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-02-29",
        "last_updated": "2022-11-28",
        "certification_date": "2022-11-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "019499-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Headway",
            "affiliation": "N",
            "address_1": "475 Clermont Ave Apt 505",
            "city": "Brooklyn",
            "state": "NY",
            "country_code": "US",
            "postal_code": "112385969",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.