Individual provider Active NPI

Stacey Katz, PH.D.

  • Clinical Psychologist
  • Rye, NY
National Provider Identifier
1225056963
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
016251 Issued in NY
Practice address
101 Theall Rd
Rye, NY 10580-1406
Phone
(914) 925-8200
NPI assigned
Jul 18, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 016251 NY Primary

Addresses

Primary practice location

101 Theall Rd
Rye, NY 10580-1406

Mailing address

1 Old Country Rd
Suite 271
Carle Place, NY 11514-1801
Phone (800) 725-6280

Other identifiers 1

IdentifierTypeStateIssuer
02709731MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20160209000037 GA Practitioner - Clinical Psychologist 4284658758 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

Practice roles

OrganizationSpecialtyStatusNew patients
CS Pacs 3 Southeast, LLC CurrentSince Jul 7, 2025 Accepting new patients
Christopher Dennis MD PLLC Clinical CurrentSince Feb 4, 2019 Accepting new patients
Inpatient Consultants of Georgia, Inc CurrentSince Jul 7, 2025 Accepting new patients

Locations

1420 Milstead Rd NE
Conyers, GA 30012
Phone (770) 483-3902

2403 Battlefield Pkwy
Ft Oglethorpe, GA 30742
Phone (423) 979-5805

11340 Lakefield Dr
Ste 200
Johns Creek, GA 30097
Phone (678) 407-2159

400 Charter Blvd
Macon, GA 31210
Phone (478) 757-6000

1425 McFarland Ave
Rossville, GA 30741
Phone (423) 987-3702

110 Park City Rd
Rossville, GA 30741
Phone (706) 858-2702

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": "1153180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1225056963",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 OLD COUNTRY RD",
            "address_2": "SUITE 271",
            "city": "CARLE PLACE",
            "state": "NY",
            "postal_code": "115141801",
            "telephone_number": "800-725-6280",
            "fax_number": "800-725-6380"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 THEALL RD",
            "city": "RYE",
            "state": "NY",
            "postal_code": "105801406",
            "telephone_number": "914-925-8200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KATZ",
        "first_name": "STACEY",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-18",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "016251",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02709731",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rye, NY

Sources for this page

Verify at the official NPI Registry.