Individual provider Active NPI

Mina Dunnam, PH.D.

  • Clinical Neuropsychologist
  • Saratoga Springs, NY
National Provider Identifier
1225134190
Registry record updated Feb 8, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical NeuropsychologistTaxonomy code 103G00000X
License
008859 Issued in NY
Practice address
7 Wells St
Suite 103
Saratoga Springs, NY 12866-1200
Phone
(518) 581-7260
Fax
(518) 633-1218
NPI assigned
Sep 16, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 8, 2015

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

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Neuropsychologist 103G00000X 008859 NY Primary
Psychologist 103T00000X 008859 NY
Adult Development & Aging Psychologist 103TA0700X 008859 NY
Clinical Psychologist 103TC0700X 008859 NY
Health Service Psychologist 103TH0100X 008859 NY
Intellectual & Developmental Disabilities Psychologist 103TM1800X 008859 NY

Addresses

Primary practice location

7 Wells St
Suite 103
Saratoga Springs, NY 12866-1200

Mailing address

7 Wells St
Suite 103
Saratoga Springs, NY 12866-1200
Phone (518) 581-7260

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)
Enrolled
Credentials
Doctor of Philosophy

Practice roles

OrganizationSpecialtyStatusNew patients
Community Care Physicians, PLLC Past Accepting new patients
Northeast Psychological Associates PLLC Psychologist PastSince Jul 1, 2019 Accepting new patients
Northeast Psychological Associates Psychologist Past Accepting new patients
Adirondack Neuropsychological Associates Clinical Neuropsychologist Past Accepting new patients

Organizations & group practices 4

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": "1158364800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1423353600000",
    "number": "1225134190",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7 WELLS ST",
            "address_2": "SUITE 103",
            "city": "SARATOGA SPRINGS",
            "state": "NY",
            "postal_code": "128661200",
            "telephone_number": "518-581-7260",
            "fax_number": "518-633-1218"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7 WELLS ST",
            "address_2": "SUITE 103",
            "city": "SARATOGA SPRINGS",
            "state": "NY",
            "postal_code": "128661200",
            "telephone_number": "518-581-7260",
            "fax_number": "518-633-1218"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUNNAM",
        "first_name": "MINA",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-16",
        "last_updated": "2015-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "NY",
            "license": "008859",
            "primary": true
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NY",
            "license": "008859",
            "primary": false
        },
        {
            "code": "103TA0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Adult Development & Aging",
            "state": "NY",
            "license": "008859",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "008859",
            "primary": false
        },
        {
            "code": "103TH0100X",
            "taxonomy_group": "",
            "desc": "Psychologist, Health Service",
            "state": "NY",
            "license": "008859",
            "primary": false
        },
        {
            "code": "103TM1800X",
            "taxonomy_group": "",
            "desc": "Psychologist, Intellectual & Developmental Disabilities",
            "state": "NY",
            "license": "008859",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saratoga Springs, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.