Southern Tier Psychology, PC

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

Legal business name

SOUTHERN TIER PSYCHOLOGY, PC

Practice address

591 State Route 244
Alfred Station, NY 14803

Phone

(585) 204-7560

NPI assigned

Aug 30, 2024

Organization subpart

No

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

Authorized official

Name

Dr. Rachel Anne Gardner, PHDNPI 1386044923

Title

Ceo/President

Phone

(585) 204-7560

Specialties & licenses 1

Addresses

Tax ID family

Southern Tier Psychology PC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Southern Tier Psychology, PC

  • Clinical Psychologist
  • Alfred Station, NY
  • NPI 1437094091
  NPD tax ID

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Rachel Anne Gardner, PH.D.

  • Health Service Psychologist
  • Alfred Station, NY
  • NPI 1386044923
  NPD Authorized official

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

{
    "created_epoch": "1724976000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1724976000000",
    "number": "1043044092",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5268 LANDIS RD",
            "city": "HORNELL",
            "state": "NY",
            "postal_code": "148439026"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "591 STATE ROUTE 244",
            "city": "ALFRED STATION",
            "state": "NY",
            "postal_code": "14803",
            "telephone_number": "585-204-7560"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN TIER PSYCHOLOGY, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-08-30",
        "last_updated": "2024-08-30",
        "certification_date": "2024-08-27",
        "status": "A",
        "authorized_official_last_name": "GARDNER",
        "authorized_official_first_name": "RACHEL",
        "authorized_official_middle_name": "ANNE",
        "authorized_official_title_or_position": "CEO/PRESIDENT",
        "authorized_official_telephone_number": "585-204-7560",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Pamela Pitt Jones, FNP C
• Sylvia Kelley Knowlton, M.D.
• Phoenix Rising Therapeutic Services LCSW PC
• Norman James Pollard, ED.D.
• Cody James Prince, FNP
• Southern Tier Psychology, PC
• Michael Wales, MASTER SCHOOL PSYCH
• Kristina Winters, M.S. CCC-SLP

• Clinical Psychologist in Alfred Station, NY
• Providers in Alfred Station, 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 Aug 30, 2024; 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.