Active NPI
Michele Caryn Sacks, PHD
- Clinical Psychologist
- Larchmont, NY
National Provider Identifier
1073636627
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 10080
- Practice address
- 48 Ellsworth Rd
Larchmont, NY 10538-1439 - Phone
- (914) 834-2652
- NPI assigned
- Apr 9, 2007
- Sex
- Female
- Sole proprietor
- Yes
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 | 10080 | NY | Primary |
Addresses
Primary practice location
48 Ellsworth Rd
Larchmont, NY 10538-1439
Mailing address
48 Ellsworth Rd
Larchmont, NY 10538-1439
Phone (914) 834-2652
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Feb 21, 2022 through Feb 21, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 10080 | NY | MD | Clinical Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Barry M. Kotel, LCSW, PC | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Clinical Social Worker
- New York, NY
- NPI 1639320815
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1176076800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1073636627",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "48 ELLSWORTH RD",
"city": "LARCHMONT",
"state": "NY",
"postal_code": "105381439",
"telephone_number": "914-834-2652"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "48 ELLSWORTH RD",
"city": "LARCHMONT",
"state": "NY",
"postal_code": "105381439",
"telephone_number": "914-834-2652"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SACKS",
"first_name": "MICHELE",
"middle_name": "CARYN",
"name_prefix": "Dr.",
"credential": "PHD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-04-09",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "NY",
"license": "10080",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Larchmont, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.