Individual provider Active NPI

Carolyn Fried Sutton, PSY.D.

  • Psychologist
  • New Paltz, NY
National Provider Identifier
1174627210
Registry record updated Apr 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
011284-1 Issued in NY
Practice address
52 S Manheim Blvd
New Paltz, NY 12561-2406
Phone
(845) 256-7004
NPI assigned
Sep 11, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 7, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 011284-1 NY Primary

Addresses

Primary practice location

52 S Manheim Blvd
New Paltz, NY 12561-2406

Mailing address

PO Box 1155
New Paltz, NY 12561-1155
Phone (845) 256-7004

Other identifiers 6

IdentifierTypeStateIssuer
351400000OtherNYMAGELLAN
V677FOtherNYEMP BC BS NSLIJ HOSP
7349256OtherNYGHI
P3617311OtherNYOXFORD
144604OtherNYVALUE OPTIONS
V1J44OtherNYEMP BL CROSS BL SHIELD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060501000093 NY Practitioner - Clinical Psychologist 1951311349 Practice locations: Highland, NY

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

24 Main St
Highland, NY 12528-1408
Phone (845) 256-7004

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
011284-1NYMDPsychologist
011284NYMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Aileen Walsh LCSW PC CurrentSince Apr 10, 2022 Accepting new patients
Hudson Dermatology, PC Past Accepting new patients
Integral Chiropractic, P.C. PastSince Nov 16, 2013 Accepting new patients

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1157932800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649289600000",
    "number": "1174627210",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1155",
            "city": "NEW PALTZ",
            "state": "NY",
            "postal_code": "125611155",
            "telephone_number": "845-256-7004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "52 S MANHEIM BLVD",
            "city": "NEW PALTZ",
            "state": "NY",
            "postal_code": "125612406",
            "telephone_number": "845-256-7004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUTTON",
        "first_name": "CAROLYN",
        "middle_name": "FRIED",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-11",
        "last_updated": "2022-04-07",
        "certification_date": "2022-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NY",
            "license": "011284-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAGELLAN",
            "identifier": "351400000",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EMP BC BS NSLIJ HOSP",
            "identifier": "V677F",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHI",
            "identifier": "7349256",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD",
            "identifier": "P3617311",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VALUE OPTIONS",
            "identifier": "144604",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EMP BL CROSS BL SHIELD",
            "identifier": "V1J44",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New Paltz, NY

Sources for this page

Verify at the official NPI Registry.