Active NPI
Dana Marie Jean-Louis, PSYD
- Clinical Psychologist
- New York, NY
National Provider Identifier
1124617402
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 025514
- Practice address
- 125 W 72ND St RM 5R
New York, NY 10023-3278 - Phone
- (718) 702-7069
- NPI assigned
- Jan 12, 2021
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Clinical Psychologist | 103TC0700X | 025514 | NY | Primary |
Addresses
Primary practice location
125 W 72ND St RM 5R
New York, NY 10023-3278
Mailing address
125 W 72ND St RM 5R
New York, NY 10023-3278
Phone (718) 702-7069
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 025514 | NY | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1610409600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1675123200000",
"number": "1124617402",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "125 W 72ND ST RM 5R",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100233278",
"telephone_number": "718-702-7069"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "125 W 72ND ST RM 5R",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100233278",
"telephone_number": "718-702-7069"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JEAN-LOUIS",
"first_name": "DANA",
"middle_name": "MARIE",
"name_prefix": "Dr.",
"credential": "PSYD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-01-12",
"last_updated": "2023-01-31",
"certification_date": "2023-01-31",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "103TC0700X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Psychologist, Clinical",
"state": "NY",
"license": "025514",
"primary": true
}
],
"identifiers": [],
"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 Jan 31, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.