Organization Active NPI

Psychological Stress Management Services PC

  • Clinical Psychologist
  • New York, NY
National Provider Identifier
1124137971
Registry record updated Dec 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
014289 Issued in NY
Legal business name
PSYCHOLOGICAL STRESS MANAGEMENT SERVICES PC
Practice address
280 Madison Ave
RM 1403
New York, NY 10016-0801
Phone
(917) 566-3840
NPI assigned
Aug 29, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 3, 2024

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

Authorized official

Name
Daniel N Guerra, PSYDNPI 1003835810
Title
President/Director
Phone
(917) 566-3840

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 014289 NY Primary

Addresses

Primary practice location

280 Madison Ave
RM 1403
New York, NY 10016-0801

Mailing address

280 Madison Ave
RM 1403
New York, NY 10016-0801
Phone (917) 566-3840

Other practice location 1

21 Old Main St Ste 204
Fishkill, NY 12524-1883
Phone (917) 566-3840

Other identifiers 1

IdentifierTypeStateIssuer
02356036MedicaidNY

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040312000542 NY Part B Supplier - Clinic/Group Practice 2062301534 Receives reassigned benefits from 1 practitioner
Practice locations: Beacon, NY; New York, NY

National Provider Directory

National Provider Directory

Locations

10 Plaza St E
Ste 1C
Brooklyn, NY 11238
Phone (718) 570-7701

21 Old Main St
Ste 204
Fishkill, NY 12524
Phone (845) 897-4100

Practitioners & affiliated clinicians

Practitioners 2

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": "1156809600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1733184000000",
    "number": "1124137971",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "280 MADISON AVE",
            "address_2": "RM 1403",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100160801",
            "telephone_number": "917-566-3840"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "280 MADISON AVE",
            "address_2": "RM 1403",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100160801",
            "telephone_number": "917-566-3840"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "21 Old Main St Ste 204",
            "address_purpose": "LOCATION",
            "city": "Fishkill",
            "state": "NY",
            "postal_code": "125241883",
            "country_code": "US",
            "telephone_number": "917-566-3840",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "PSYCHOLOGICAL STRESS MANAGEMENT SERVICES PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-29",
        "last_updated": "2024-12-03",
        "certification_date": "2024-12-03",
        "status": "A",
        "authorized_official_last_name": "GUERRA",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_middle_name": "N",
        "authorized_official_title_or_position": "PRESIDENT/DIRECTOR",
        "authorized_official_telephone_number": "917-566-3840",
        "authorized_official_credential": "PSYD"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "014289",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02356036",
            "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 Dec 3, 2024; 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.