Active NPI
Brad Lindell
- Clinical Psychologist
- Miller Place, NY
National Provider Identifier
1225844996
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 009882
- Practice address
- 127 Echo Ave
Miller Place, NY 11764-2205 - Phone
- (516) 551-0542
- NPI assigned
- Dec 9, 2024
- 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 |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 009882 | NY | Primary |
Addresses
Primary practice location
127 Echo Ave
Miller Place, NY 11764-2205
Mailing address
127 Echo Ave
Miller Place, NY 11764-2205
Phone (516) 551-0542
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 |
|---|---|---|---|
| 009882 | NY | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1733702400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1733702400000",
"number": "1225844996",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "127 ECHO AVE",
"city": "MILLER PLACE",
"state": "NY",
"postal_code": "117642205",
"telephone_number": "516-551-0542"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "127 ECHO AVE",
"city": "MILLER PLACE",
"state": "NY",
"postal_code": "117642205",
"telephone_number": "516-551-0542"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LINDELL",
"first_name": "BRAD",
"name_prefix": "Dr.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2024-12-09",
"last_updated": "2024-12-09",
"certification_date": "2024-12-08",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "NY",
"license": "009882",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Miller Place, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.