Kelly Workman, BCBA, PSYD

Primary specialty

Cognitive & Behavioral PsychologistTaxonomy code 103TB0200X

License

023180 Issued in NY

Practice address

51 W 51St St
New York, NY 10019

Phone

(212) 326-8441

NPI assigned

Feb 20, 2012

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Mar 11, 2024 through Mar 11, 2028

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1329696000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1564963200000",
    "number": "1164795316",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "51 W 51ST ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100196113",
            "telephone_number": "212-326-8441"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "51 W 51ST ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "10019",
            "telephone_number": "212-326-8441"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "147 E Olive Ave",
            "address_purpose": "LOCATION",
            "city": "Monrovia",
            "state": "CA",
            "postal_code": "910163407",
            "country_code": "US",
            "telephone_number": "866-727-8274",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "129 Church St Ste 807",
            "address_purpose": "LOCATION",
            "city": "New Haven",
            "state": "CT",
            "postal_code": "065102005",
            "country_code": "US",
            "telephone_number": "626-485-5463",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "51 W 51st St",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "10019",
            "country_code": "US",
            "telephone_number": "212-326-8441",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WORKMAN",
        "first_name": "KELLY",
        "credential": "BCBA, PSYD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-02-20",
        "last_updated": "2019-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": "1-10-7776",
            "primary": false
        },
        {
            "code": "103TB0200X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Psychologist, Cognitive & Behavioral",
            "state": "CT",
            "license": "3814",
            "primary": false
        },
        {
            "code": "103TB0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Cognitive & Behavioral",
            "state": "NY",
            "license": "023180",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Cognitive & Behavioral Psychologist in New York, NY
• Providers in New York, NY by specialty
• Cognitive & Behavioral Psychologist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.