Individual provider Active NPI

Kristin Lemaster Kunkle, PSY.D.

  • Clinical Psychologist
  • New York, NY
National Provider Identifier
1184042962
Registry record updated Sep 18, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
021312-1 Issued in NY
Practice address
3 Columbus Cir
Suite 1425
New York, NY 10019-1903
Phone
(212) 246-5740
Fax
(212) 246-5792
NPI assigned
Mar 31, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 18, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 021312-1 NY Primary

Addresses

Primary practice location

3 Columbus Cir
Suite 1425
New York, NY 10019-1903

Mailing address

3 Columbus Cir
Suite 1425
New York, NY 10019-1903
Phone (212) 246-5736

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.
Opted out of Medicare
Yes, effective Oct 1, 2018 through Oct 1, 2026

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
021312-1NYMDDental Hygienist

NPI Registry JSON

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

{
    "created_epoch": "1396224000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1442534400000",
    "number": "1184042962",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 COLUMBUS CIR",
            "address_2": "SUITE 1425",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100191903",
            "telephone_number": "212-246-5736",
            "fax_number": "212-246-5792"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 COLUMBUS CIR",
            "address_2": "SUITE 1425",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100191903",
            "telephone_number": "212-246-5740",
            "fax_number": "212-246-5792"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUNKLE",
        "first_name": "KRISTIN",
        "middle_name": "LEMASTER",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-03-31",
        "last_updated": "2015-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "021312-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.