Active NPI
Madeline Caulfield McKeon, PHD
- Clinical Psychologist
- Brooklyn, NY
National Provider Identifier
1053022996
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 119365-01
- Practice address
- 109 N 12TH St Ste 507
Brooklyn, NY 11249-1002 - Phone
- (134) 797-0675
- NPI assigned
- Dec 12, 2022
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 119365-01 | NY | Primary |
Addresses
Primary practice location
109 N 12TH St Ste 507
Brooklyn, NY 11249-1002
Mailing address
6933 Olcott St
Forest Hills, NY 11375-6636
Phone (321) 960-6602
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 119365-01 | NY | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1670803200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1670803200000",
"number": "1053022996",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6933 OLCOTT ST",
"city": "FOREST HILLS",
"state": "NY",
"postal_code": "113756636",
"telephone_number": "321-960-6602"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "109 N 12TH ST STE 507",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112491002",
"telephone_number": "134-797-0675"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCKEON",
"first_name": "MADELINE",
"middle_name": "CAULFIELD",
"name_prefix": "Dr.",
"credential": "PHD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-12-12",
"last_updated": "2022-12-12",
"certification_date": "2022-12-12",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "NY",
"license": "119365-01",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Brooklyn, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.