Organization Active NPI

Senior Connections Psychological Services of New York, PC

  • Clinical Psychologist
  • Liberty, NY
National Provider Identifier
1033382601
Registry record updated Apr 3, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
Legal business name
SENIOR CONNECTIONS PSYCHOLOGICAL SERVICES OF NEW YORK, PC
Practice address
256 Sunset Lake Rd
Liberty, NY 12754-2847
Phone
(832) 448-2800
Fax
(832) 448-2801
NPI assigned
Apr 3, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 3, 2008

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

Authorized official

Name
Dr. Stephen A Daniel, PHD
Title
Owner
Phone
(832) 448-2830

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TC0700X Primary

Addresses

Primary practice location

256 Sunset Lake Rd
Liberty, NY 12754-2847

Mailing address

12012 Wickchester LN
Suite 550
Houston, TX 77079-1229
Phone (832) 448-2800

Other identifiers 1

IdentifierTypeStateIssuer
02668179MedicaidNY

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1207180800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1207180800000",
    "number": "1033382601",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12012 WICKCHESTER LN",
            "address_2": "SUITE 550",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770791229",
            "telephone_number": "832-448-2800",
            "fax_number": "832-448-2801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "256 SUNSET LAKE RD",
            "city": "LIBERTY",
            "state": "NY",
            "postal_code": "127542847",
            "telephone_number": "832-448-2800",
            "fax_number": "832-448-2801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SENIOR CONNECTIONS PSYCHOLOGICAL SERVICES OF NEW YORK, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-03",
        "last_updated": "2008-04-03",
        "status": "A",
        "authorized_official_last_name": "DANIEL",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "832-448-2830",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02668179",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Liberty, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.