Active NPI
Christa D. Labouliere, PHD
- Psychologist
- New York, NY
National Provider Identifier
1144684739
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 21453
- Practice address
- 275 Central Park W Apt 1a
New York, NY 10024-3035 - Phone
- (917) 960-7744
- NPI assigned
- Apr 8, 2016
- 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 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Cognitive & Behavioral Psychologist | 103TB0200X | 21453 | NY | |
| Clinical Psychologist | 103TC0700X | 21453 | NY | |
| Clinical Child & Adolescent Psychologist | 103TC2200X | 21453 | NY | |
| Psychologist | 103T00000X | 21453 | NY | Primary |
Addresses
Primary practice location
275 Central Park W Apt 1a
New York, NY 10024-3035
Mailing address
275 Central Park W Apt 1a
New York, NY 10024-3035
Phone (917) 960-7744
Other names 1
- Mrs. Christa D. Labouliere-Edwards
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
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 21453 | NY | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1460073600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1612224000000",
"number": "1144684739",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "275 CENTRAL PARK W APT 1A",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100243035",
"telephone_number": "917-960-7744"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "275 CENTRAL PARK W APT 1A",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100243035",
"telephone_number": "917-960-7744"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LABOULIERE",
"first_name": "CHRISTA",
"middle_name": "D.",
"name_prefix": "Dr.",
"credential": "PHD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2016-04-08",
"last_updated": "2021-02-02",
"certification_date": "2021-02-02",
"status": "A"
},
"taxonomies": [
{
"code": "103TB0200X",
"taxonomy_group": "",
"desc": "Psychologist, Cognitive & Behavioral",
"state": "NY",
"license": "21453",
"primary": false
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "NY",
"license": "21453",
"primary": false
},
{
"code": "103TC2200X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical Child & Adolescent",
"state": "NY",
"license": "21453",
"primary": false
},
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "NY",
"license": "21453",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "CHRISTA",
"last_name": "LABOULIERE-EDWARDS",
"middle_name": "D.",
"prefix": "MRS.",
"credential": "PHD",
"code": "5",
"type": "Other Name"
}
]
}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 Feb 2, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.