Active NPI
Stacey Devaux, PSY.D.
- Psychologist
- Miller Place, NY
National Provider Identifier
1154893550
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 016842
- Practice address
- 565 Route 25a Ste 201
Miller Place, NY 11764-2600 - Phone
- (631) 828-0307
- NPI assigned
- Dec 23, 2018
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | 016842 | NY | Primary |
Addresses
Primary practice location
565 Route 25a Ste 201
Miller Place, NY 11764-2600
Mailing address
72 Van Buren St
Port Jeff Sta, NY 11776-3172
Phone (163) 182-8030
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 016842 | Other | NY | LICENSE |
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 |
|---|---|---|---|
| 016842 | NY | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1545523200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1545523200000",
"number": "1154893550",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "72 VAN BUREN ST",
"city": "PORT JEFF STA",
"state": "NY",
"postal_code": "117763172",
"telephone_number": "163-182-8030"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "565 ROUTE 25A STE 201",
"city": "MILLER PLACE",
"state": "NY",
"postal_code": "117642600",
"telephone_number": "631-828-0307"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DEVAUX",
"first_name": "STACEY",
"name_prefix": "Dr.",
"credential": "PSY.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-12-23",
"last_updated": "2018-12-23",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "NY",
"license": "016842",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSE",
"identifier": "016842",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Miller Place, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.