Active NPI
Stephen Bruce Kildare, PSYD
- Psychologist
- Mount Vernon, NY
National Provider Identifier
1225357692
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 013783
- Practice address
- 500 E 5TH St
Mount Vernon, NY 10553-2115 - Phone
- (914) 667-1128
- NPI assigned
- May 25, 2010
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Psychologist | 103T00000X | 013783 | NY | Primary |
Addresses
Primary practice location
500 E 5TH St
Mount Vernon, NY 10553-2115
Mailing address
500 E 5TH St
Mount Vernon, NY 10553-2115
Phone (914) 667-1128
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 013783 | NY | MD | Chiropractor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Psychological Consultation and Therapy Services, PLLC | 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.
-
- Clinical Psychologist
- Yonkers, NY
- NPI 1154338242
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1274745600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1274745600000",
"number": "1225357692",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "500 E 5TH ST",
"city": "MOUNT VERNON",
"state": "NY",
"postal_code": "105532115",
"telephone_number": "914-667-1128"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "500 E 5TH ST",
"city": "MOUNT VERNON",
"state": "NY",
"postal_code": "105532115",
"telephone_number": "914-667-1128"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KILDARE",
"first_name": "STEPHEN",
"middle_name": "BRUCE",
"name_prefix": "Dr.",
"credential": "PSYD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2010-05-25",
"last_updated": "2010-05-25",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "NY",
"license": "013783",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mount Vernon, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.