Individual provider Active NPI

Allyson Havill, PHD

  • Clinical Psychologist
  • Pine Bush, NY
National Provider Identifier
1124227269
Registry record updated Mar 19, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
026482-01 Issued in NY
Practice address
127 State Route 302 Ste 4
Pine Bush, NY 12566-7134
Phone
(724) 814-1492
NPI assigned
Jul 17, 2007
Last updated
Mar 19, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 19, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PS019997 PA
Clinical Psychologist 103TC0700X 026482-01 NY Primary

Addresses

Primary practice location

127 State Route 302 Ste 4
Pine Bush, NY 12566-7134

Mailing address

64 Bert McCord Dr
Pine Bush, NY 12566-5344
Phone (845) 654-7267

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240805002184 NY Practitioner - Clinical Psychologist 6204006232 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Brightside Medical PCGroup PAC ID 4082089461, 64 clinicians

Practice addresses (Care Compare)

2263 James St
Suite 523
Syracuse, NY 13206-3262
Phone (415) 360-3348

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
026482-01NYMDClinical Psychologist
PS019997PAMDClinical Psychologist
026482NYMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Che Senior Psychological Services, PC Clinical CurrentSince Jul 15, 2024 Accepting new patients
Knapp Street Psychiatry, PC Clinical CurrentSince Jul 15, 2024 Accepting new patients
Brightside Medical, P.C. CurrentSince May 1, 2025 Accepting new patients
Allyson Havill PHD Clinical CurrentSince Jun 30, 2024 Accepting new patients
Francis C Harris Past Accepting new patients

Locations

2261 Market St
San Francisco, CA 94114
Phone (213) 337-4615

1915 Ocean Ave
Brooklyn, NY 11230
Phone (718) 258-7700

300 Cadman Plz W
Fl 12
Brooklyn Heights, NY 11201
Phone (212) 439-7955

250 Beach 17th St
Far Rockaway, NY 11691
Phone (516) 670-0212

127 State Route 302
Ste 4
Pine Bush, NY 12566
Phone (724) 814-1492

209 Beach 125th St
Rockaway Park, NY 11694
Phone (516) 721-7625

135 Vanderbilt Ave
Staten Island, NY 10304
Phone (718) 420-1934

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1184630400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773878400000",
    "number": "1124227269",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "64 BERT MCCORD DR",
            "city": "PINE BUSH",
            "state": "NY",
            "postal_code": "125665344",
            "telephone_number": "845-654-7267"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "127 STATE ROUTE 302 STE 4",
            "city": "PINE BUSH",
            "state": "NY",
            "postal_code": "125667134",
            "telephone_number": "724-814-1492"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAVILL",
        "first_name": "ALLYSON",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-07-17",
        "last_updated": "2026-03-19",
        "certification_date": "2026-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "PA",
            "license": "PS019997",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "026482-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pine Bush, NY

Sources for this page

Verify at the official NPI Registry.