Individual provider Active NPI

Siriporn Jenny Klein, PSYD

  • Clinical Psychologist
  • New York, NY
National Provider Identifier
1295291078
Registry record updated Mar 4, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
022968-1 Issued in NY
Practice address
353 Lexington Ave
# 308
New York, NY 10016-0941
Phone
(917) 601-7486
NPI assigned
Feb 16, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 4, 2021

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 022968-1 NY Primary

Addresses

Primary practice location

353 Lexington Ave
# 308
New York, NY 10016-0941

Mailing address

1124 31St Ave
Apt 6E
Astoria, NY 11106-4878
Phone (917) 601-7486

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Jul 31, 2025 through Jul 31, 2027

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
022968-1NYMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1550275200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614816000000",
    "number": "1295291078",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1124 31ST AVE",
            "address_2": "APT 6E",
            "city": "ASTORIA",
            "state": "NY",
            "postal_code": "111064878",
            "telephone_number": "917-601-7486"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "353 LEXINGTON AVE",
            "address_2": "# 308",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100160941",
            "telephone_number": "917-601-7486"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KLEIN",
        "first_name": "SIRIPORN",
        "middle_name": "JENNY",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-02-16",
        "last_updated": "2021-03-04",
        "certification_date": "2021-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "022968-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.