Alison Rose Soep, PSY.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

024797 Issued in NY

Practice address

1067 Mora PL
Woodmere, NY 11598-1113

Phone

(516) 776-5898

NPI assigned

Jul 21, 2021

Reactivated

Sep 9, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Avital Soep Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1626825600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1647907200000",
    "number": "1073186755",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1067 MORA PL",
            "city": "WOODMERE",
            "state": "NY",
            "postal_code": "115981113",
            "telephone_number": "516-776-5898"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1067 MORA PL",
            "city": "WOODMERE",
            "state": "NY",
            "postal_code": "115981113",
            "telephone_number": "516-776-5898"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1620 Caton Ave Apt 3B",
            "address_purpose": "LOCATION",
            "city": "Brooklyn",
            "state": "NY",
            "postal_code": "112261036",
            "country_code": "US",
            "telephone_number": "917-905-7330 x802",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SOEP",
        "first_name": "ALISON",
        "middle_name": "ROSE",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-07-21",
        "last_updated": "2022-03-22",
        "certification_date": "2022-02-15",
        "deactivation_date": "2021-07-21",
        "reactivation_date": "2021-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "024797",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AVITAL",
            "last_name": "SOEP",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Ausjiaunna Kiarany-Breaira Smith
• Jamiesha Smith
• Marquitta Smith
• Robert C. Smith, M.D.
• Adina Snow
• Melany Solomon, M.S.
• Nancy Spadaford
• Ariella Spector
• Ariana V Speziale, OTR/L
• Tova Sprecher- Markowitz, LMHC

• Clinical Psychologist in Woodmere, NY
• Providers in Woodmere, 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 Mar 22, 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.

Verify at the official NPI Registry.