Charles Schaeffer, PH.D

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

021761 Issued in NY

Practice address

31 Washington SQ W
Suite 5R
New York, NY 10011-9126

Phone

(718) 577-1564

NPI assigned

Sep 2, 2016

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1472774400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1472774400000",
    "number": "1265989628",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "315 8TH AVE",
            "address_2": "APT 17",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112156621"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31 WASHINGTON SQ W",
            "address_2": "SUITE 5R",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100119126",
            "telephone_number": "718-577-1564"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHAEFFER",
        "first_name": "CHARLES",
        "name_prefix": "Dr.",
        "credential": "PH.D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-09-02",
        "last_updated": "2016-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "021761",
            "primary": true
        },
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "NY",
            "license": "021761",
            "primary": false
        },
        {
            "code": "103TH0004X",
            "taxonomy_group": "",
            "desc": "Psychologist, Health",
            "state": "NY",
            "license": "021761",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kenneth Barry Schaefer, M.D.
• Michael John Schaefer Jr., M.D.
• Paulina Joy Schaefer
• Steven David Schaefer, M.D.
• Bradley Schaeffer, DPM
• Damian Schaeffer
• Deborah Schaeffer
• Kassidy Ann Schaeffer, PA-C
• Lorena Schaeffer, LMSW
• Marissa Tamar Schaeffer, PT, DPT, CSCS

• Clinical Psychologist in New York, NY
• Providers in New York, NY by specialty
• Clinical Psychologist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2016; 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.