Individual provider Active NPI

Nancy Maclachlan Shuster, PH.D.

  • Clinical Psychologist
  • Kingston, NY
National Provider Identifier
1114056660
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
010976 Issued in NY
Practice address
41 Pearl St
Kingston, NY 12401-4552
Phone
(845) 338-3422
Fax
(845) 687-0814
NPI assigned
Mar 2, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 010976 NY Primary

Addresses

Primary practice location

41 Pearl St
Kingston, NY 12401-4552

Mailing address

41 Pearl St
Kingston, NY 12401-4552
Phone (845) 338-3422

Other identifiers 1

IdentifierTypeStateIssuer
S10976-9OtherNYWORKER COMPENSATION BOARD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.
Opted out of Medicare
Yes, effective Jul 1, 2014 through Jul 1, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
010976NYMDMassage Therapist

NPI Registry JSON

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

{
    "created_epoch": "1172793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1114056660",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "41 PEARL ST",
            "city": "KINGSTON",
            "state": "NY",
            "postal_code": "124014552",
            "telephone_number": "845-338-3422",
            "fax_number": "845-687-0814"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "41 PEARL ST",
            "city": "KINGSTON",
            "state": "NY",
            "postal_code": "124014552",
            "telephone_number": "845-338-3422",
            "fax_number": "845-687-0814"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHUSTER",
        "first_name": "NANCY",
        "middle_name": "MACLACHLAN",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-02",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "010976",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WORKER COMPENSATION BOARD",
            "identifier": "S10976-9",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kingston, NY

Sources for this page

Verify at the official NPI Registry.