Active NPI
Johanna Semple Herwitz
- Clinical Psychologist
- New York, NY
National Provider Identifier
1194368209
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 16658
- Practice address
- 750 Park Ave Apt 1C
New York, NY 10021-4386 - Phone
- (212) 327-3624
- NPI assigned
- Oct 21, 2019
- 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 |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 16658 | NY | Primary |
Addresses
Primary practice location
750 Park Ave Apt 1C
New York, NY 10021-4386
Mailing address
1040 Park Ave # 2J
New York, NY 10028-1032
Phone (212) 410-6845
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 |
|---|---|---|---|
| 16658 | NY | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1571616000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1571616000000",
"number": "1194368209",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1040 PARK AVE # 2J",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100281032",
"telephone_number": "212-410-6845",
"fax_number": "212-828-8732"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "750 PARK AVE APT 1C",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100214386",
"telephone_number": "212-327-3624"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HERWITZ",
"first_name": "JOHANNA",
"middle_name": "SEMPLE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-10-21",
"last_updated": "2019-10-21",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "NY",
"license": "16658",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
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 Oct 21, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.