Individual provider Active NPI

Linda Kestenbaum, PH.D.

  • Clinical Psychologist
  • New York, NY
National Provider Identifier
1124230529
Registry record updated Feb 1, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
6005 Issued in NY
Practice address
142 W End Ave
Apt. 19N
New York, NY 10023-6103
Phone
(212) 799-6373
NPI assigned
May 6, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 1, 2015

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 6005 NY Primary

Addresses

Primary practice location

142 W End Ave
Apt. 19N
New York, NY 10023-6103

Mailing address

142 W End Ave
Apt. 19N
New York, NY 10023-6103
Phone (212) 799-6373

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 Apr 1, 2013 through Apr 1, 2027

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
6005NYMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1178409600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1422748800000",
    "number": "1124230529",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "142 W END AVE",
            "address_2": "APT. 19N",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100236103",
            "telephone_number": "212-799-6373"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "142 W END AVE",
            "address_2": "APT. 19N",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100236103",
            "telephone_number": "212-799-6373"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KESTENBAUM",
        "first_name": "LINDA",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-06",
        "last_updated": "2015-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "6005",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.