Individual provider Active NPI

Shirlee Taylor, PH.D.

  • Clinical Psychologist
  • New York, NY
National Provider Identifier
1215185368
Registry record updated Aug 25, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
017621-1 Issued in NY
Practice address
928 Broadway
Suite 902
New York, NY 10010-6008
Phone
(212) 982-8477
Fax
(212) 982-8477
NPI assigned
Sep 3, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 25, 2011

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 017621-1 NY Primary

Addresses

Primary practice location

928 Broadway
Suite 902
New York, NY 10010-6008

Mailing address

928 Broadway
Suite 902
New York, NY 10010-6008
Phone (212) 982-8477

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Feb 28, 2024 through Feb 29, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
017621-1NYMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Nyumc Pediatric Cardiology Past Accepting new patients

Organizations & group practices 1

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": "1220400000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1314230400000",
    "number": "1215185368",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "928 BROADWAY",
            "address_2": "SUITE 902",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100106008",
            "telephone_number": "212-982-8477",
            "fax_number": "212-982-8477"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "928 BROADWAY",
            "address_2": "SUITE 902",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100106008",
            "telephone_number": "212-982-8477",
            "fax_number": "212-982-8477"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAYLOR",
        "first_name": "SHIRLEE",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-09-03",
        "last_updated": "2011-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "017621-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.