Active NPI
Annie Ackerman, PH.D.
- Psychologist
- New York, NY
National Provider Identifier
1174961007
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- Practice address
- 302 5TH Ave Ste 1117
New York, NY 10001-3604 - Phone
- (860) 631-7701
- NPI assigned
- Jun 13, 2013
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 022838 | NY | |
| Psychologist | 103T00000X | Primary |
Addresses
Primary practice location
302 5TH Ave Ste 1117
New York, NY 10001-3604
Mailing address
302 5TH Ave Ste 1117
New York, NY 10001-3604
Phone (917) 771-1841
Other names 1
- Annee Ackerman
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 |
|---|---|---|---|
| 022838 | NY | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1371081600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1641427200000",
"number": "1174961007",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "302 5TH AVE STE 1117",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100013604",
"telephone_number": "917-771-1841"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "302 5TH AVE STE 1117",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100013604",
"telephone_number": "860-631-7701"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ACKERMAN",
"first_name": "ANNIE",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2013-06-13",
"last_updated": "2022-01-06",
"certification_date": "2022-01-06",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "NY",
"license": "022838",
"primary": false
},
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "ANNEE",
"last_name": "ACKERMAN",
"credential": "PH.D.",
"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 Jan 6, 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.