Individual provider Active NPI

Scott Michael Sokol, PH.D.

  • Clinical Psychologist
  • New York, NY
National Provider Identifier
1063602118
Registry record updated Apr 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
011864 Issued in NY
Practice address
411 W 114TH St
New York, NY 10025-1710
Phone
(508) 505-8677
NPI assigned
Jul 25, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 17, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 011864 NY Primary
Clinical Neuropsychologist 103G00000X 6314 MA

Addresses

Primary practice location

411 W 114TH St
New York, NY 10025-1710

Mailing address

815 Pepperidge Rd
Westbury, NY 11590-1436
Phone (508) 505-8677

Other practice location 1

815 Pepperidge Rd
Westbury, NY 11590-1436
Phone (508) 505-8677

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
I20230316001232 NY Practitioner - Clinical Psychologist 0648644583 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
6314MAMDMental Health Counselor
011864NYMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Icahn School of Medicine at Mount Sinai CurrentSince Mar 1, 2023 Accepting new patients
Icahn School of Medicine at Mount Sinai CurrentSince Mar 1, 2023 Accepting new patients

Locations

150 E 42nd St
Fl 10
New York, NY 10017
Phone (646) 605-8119

1425 Madison Ave
New York, NY 10029
Phone (212) 824-8150

Organizations & group practices 2

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": "1185321600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681689600000",
    "number": "1063602118",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "815 PEPPERIDGE RD",
            "city": "WESTBURY",
            "state": "NY",
            "postal_code": "115901436",
            "telephone_number": "508-505-8677"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "411 W 114TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100251710",
            "telephone_number": "508-505-8677"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "815 Pepperidge Rd",
            "address_purpose": "LOCATION",
            "city": "Westbury",
            "state": "NY",
            "postal_code": "115901436",
            "country_code": "US",
            "telephone_number": "508-505-8677",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SOKOL",
        "first_name": "SCOTT",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-07-25",
        "last_updated": "2023-04-17",
        "certification_date": "2023-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "011864",
            "primary": true
        },
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "MA",
            "license": "6314",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.