Integrative Psychological Professional Service, PLLC

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

Legal business name

INTEGRATIVE PSYCHOLOGICAL PROFESSIONAL SERVICE, PLLC

Practice address

3 E Evergreen Rd
New City, NY 10956-5101

Phone

(845) 579-5728

Fax

(845) 845-3357

NPI assigned

Apr 22, 2022

Organization subpart

No

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

Authorized official

Name

Chanelle Richards, PHDNPI 1992922801

Title

Owner/Psychologist

Phone

(845) 579-5728

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Chanelle Richards, PH.D.

  • Clinical Psychologist
  • New City, NY
  • NPI 1992922801
  NPD Authorized official

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

{
    "created_epoch": "1650585600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1650585600000",
    "number": "1124762455",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 NELSON LN",
            "city": "CONGERS",
            "state": "NY",
            "postal_code": "109201109",
            "telephone_number": "718-541-6453"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 E EVERGREEN RD",
            "city": "NEW CITY",
            "state": "NY",
            "postal_code": "109565101",
            "telephone_number": "845-579-5728",
            "fax_number": "845-845-3357"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 International Blvd",
            "address_purpose": "LOCATION",
            "city": "Mahwah",
            "state": "NJ",
            "postal_code": "074950027",
            "country_code": "US",
            "telephone_number": "845-579-5728",
            "fax_number": "845-335-7097",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "INTEGRATIVE PSYCHOLOGICAL PROFESSIONAL SERVICE, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-04-22",
        "last_updated": "2022-04-22",
        "certification_date": "2022-04-22",
        "status": "A",
        "authorized_official_last_name": "RICHARDS",
        "authorized_official_first_name": "CHANELLE",
        "authorized_official_title_or_position": "OWNER/PSYCHOLOGIST",
        "authorized_official_telephone_number": "845-579-5728",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Psychologist in New City, NY
• Providers in New City, NY by specialty
• Clinical Psychologist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.