Individual provider Active NPI

Nancy Mina Freeman-Carroll, PSY.D.

  • Clinical Psychologist
  • New York, NY
National Provider Identifier
1124247283
Registry record updated Jan 26, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
012527-1 Issued in NY
Practice address
350 Central Park W
13E
New York, NY 10025-6547
Phone
(212) 665-0442
NPI assigned
Apr 25, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 26, 2011

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

Specialties & licenses 13

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 012527-1 NY
Addiction (Substance Use Disorder) Psychologist 103TA0400X 012527-1 NY
Adult Development & Aging Psychologist 103TA0700X 012527-1 NY
Clinical Psychologist 103TC0700X 012527-1 NY Primary
Counseling Psychologist 103TC1900X 012527-01 NY
Clinical Child & Adolescent Psychologist 103TC2200X 012527-01 NY
Family Psychologist 103TF0000X 012527-1 NY
Forensic Psychologist 103TF0200X 012527-1 NY
Health Service Psychologist 103TH0100X 012527-1 NY
Intellectual & Developmental Disabilities Psychologist 103TM1800X 012527-1 NY
Psychoanalysis Psychologist 103TP0814X 012527-1 NY
Group Psychotherapy Psychologist 103TP2701X 012527-1 NY
School Psychologist 103TS0200X 012527-1 NY

Addresses

Primary practice location

350 Central Park W
13E
New York, NY 10025-6547

Mailing address

350 Central Park W
13E
New York, NY 10025-6547
Phone (212) 665-0442

Other names 1

  • Dr. Nancy Mina Freeman Professional name

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
I20080729000532 NY Practitioner - Clinical Psychologist 1759455447 Practice locations: New York, NY

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

350 Central Park W
Suite 13E
New York, NY 10025-0019
Phone (212) 665-0442

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
012527-01NYMDClinical Child & Adolescent Psychologist
012527-1NYMDForensic Psychologist
012527NYMDChiropractor

NPI Registry JSON

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

{
    "created_epoch": "1177459200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1296000000000",
    "number": "1124247283",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "350 CENTRAL PARK W",
            "address_2": "13E",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100256547",
            "telephone_number": "212-665-0442"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350 CENTRAL PARK W",
            "address_2": "13E",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100256547",
            "telephone_number": "212-665-0442"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FREEMAN-CARROLL",
        "first_name": "NANCY",
        "middle_name": "MINA",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-25",
        "last_updated": "2011-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NY",
            "license": "012527-1",
            "primary": false
        },
        {
            "code": "103TA0400X",
            "taxonomy_group": "",
            "desc": "Psychologist, Addiction (Substance Use Disorder)",
            "state": "NY",
            "license": "012527-1",
            "primary": false
        },
        {
            "code": "103TA0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Adult Development & Aging",
            "state": "NY",
            "license": "012527-1",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "012527-1",
            "primary": true
        },
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "NY",
            "license": "012527-01",
            "primary": false
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "NY",
            "license": "012527-01",
            "primary": false
        },
        {
            "code": "103TF0000X",
            "taxonomy_group": "",
            "desc": "Psychologist, Family",
            "state": "NY",
            "license": "012527-1",
            "primary": false
        },
        {
            "code": "103TF0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Forensic",
            "state": "NY",
            "license": "012527-1",
            "primary": false
        },
        {
            "code": "103TH0100X",
            "taxonomy_group": "",
            "desc": "Psychologist, Health Service",
            "state": "NY",
            "license": "012527-1",
            "primary": false
        },
        {
            "code": "103TM1800X",
            "taxonomy_group": "",
            "desc": "Psychologist, Intellectual & Developmental Disabilities",
            "state": "NY",
            "license": "012527-1",
            "primary": false
        },
        {
            "code": "103TP0814X",
            "taxonomy_group": "",
            "desc": "Psychologist, Psychoanalysis",
            "state": "NY",
            "license": "012527-1",
            "primary": false
        },
        {
            "code": "103TP2701X",
            "taxonomy_group": "",
            "desc": "Psychologist, Group Psychotherapy",
            "state": "NY",
            "license": "012527-1",
            "primary": false
        },
        {
            "code": "103TS0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, School",
            "state": "NY",
            "license": "012527-1",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NANCY",
            "last_name": "FREEMAN",
            "middle_name": "MINA",
            "prefix": "DR.",
            "credential": "PSY.D.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.