Active NPI
Shirley Ann Rosario-Perez, PHD
- Clinical Psychologist
- Buffalo, NY
National Provider Identifier
1063200178
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 6301019664
- Practice address
- 3495 Bailey Ave
MH Services
Buffalo, NY 14215 - Phone
- (716) 834-9200
- NPI assigned
- Apr 28, 2025
- 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 | 6301019664 | MI | Primary |
Addresses
Primary practice location
3495 Bailey Ave
MH Services
Buffalo, NY 14215
Mailing address
1050 Carter Dr
Grand Island, NY 14072-2608
Phone (616) 666-1488
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 |
|---|---|---|---|
| 6301019664 | MI | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1745798400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1745798400000",
"number": "1063200178",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1050 CARTER DR",
"city": "GRAND ISLAND",
"state": "NY",
"postal_code": "140722608",
"telephone_number": "616-666-1488"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3495 BAILEY AVE",
"address_2": "MH SERVICES",
"city": "BUFFALO",
"state": "NY",
"postal_code": "14215",
"telephone_number": "716-834-9200"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROSARIO-PEREZ",
"first_name": "SHIRLEY",
"middle_name": "ANN",
"name_prefix": "Dr.",
"credential": "PHD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2025-04-28",
"last_updated": "2025-04-28",
"certification_date": "2025-04-28",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "MI",
"license": "6301019664",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Buffalo, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.