Active NPI
Andrea Allen, PHD
- Psychologist
- New York, NY
National Provider Identifier
1124116785
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 012971
- Practice address
- 85 5TH Ave
Suite 921
New York, NY 10003-3019 - Phone
- (212) 989-4780
- NPI assigned
- Oct 10, 2006
- 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 |
|---|---|---|---|---|
| Psychologist | 103T00000X | 012971 | NY | Primary |
Addresses
Primary practice location
85 5TH Ave
Suite 921
New York, NY 10003-3019
Mailing address
85 5TH Ave
Suite 921
New York, NY 10003-3019
Phone (212) 989-4780
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 01718863 | Medicaid | NY |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Mar 3, 2020 through Mar 3, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160438400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1124116785",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "85 5TH AVE",
"address_2": "SUITE 921",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100033019",
"telephone_number": "212-989-4780"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "85 5TH AVE",
"address_2": "SUITE 921",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100033019",
"telephone_number": "212-989-4780"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ALLEN",
"first_name": "ANDREA",
"name_prefix": "Dr.",
"credential": "PHD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-10-10",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "NY",
"license": "012971",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "01718863",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in New York, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 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.