Organization Active NPI

Catskill Mountain Psychology PLLC

  • Clinical Psychologist
  • Kingston, NY
National Provider Identifier
1073992178
Registry record updated Sep 21, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
7948 Issued in NY
Legal business name
CATSKILL MOUNTAIN PSYCHOLOGY PLLC
Practice address
159 Green St
Kingston, NY 12401-3736
Phone
(845) 331-2007
Fax
(845) 339-2382
NPI assigned
May 21, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 21, 2015

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

Authorized official

Name
Dr. Lawrence Dresdale, PH.D.NPI 1689791352
Title
Sole Member
Phone
(845) 331-2007

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103TC0700X 7948 NY Primary

Addresses

Primary practice location

159 Green St
Kingston, NY 12401-3736

Mailing address

50 Lauren CT
Kingston, NY 12401-7207
Phone (914) 388-9254

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150724010593 NY Part B Supplier - Clinic/Group Practice 5193038792 Receives reassigned benefits from 1 practitioner
Practice locations: Kingston, NY

National Provider Directory

National Provider Directory

Locations

721 Broadway
#201
Kingston, NY 12401
Phone (845) 331-2007

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1432166400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1442793600000",
    "number": "1073992178",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50 LAUREN CT",
            "city": "KINGSTON",
            "state": "NY",
            "postal_code": "124017207",
            "telephone_number": "914-388-9254"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "159 GREEN ST",
            "city": "KINGSTON",
            "state": "NY",
            "postal_code": "124013736",
            "telephone_number": "845-331-2007",
            "fax_number": "845-339-2382"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CATSKILL MOUNTAIN PSYCHOLOGY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-05-21",
        "last_updated": "2015-09-21",
        "status": "A",
        "authorized_official_last_name": "DRESDALE",
        "authorized_official_first_name": "LAWRENCE",
        "authorized_official_title_or_position": "SOLE MEMBER",
        "authorized_official_telephone_number": "845-331-2007",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "7948",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kingston, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.