Active NPI
Melinda Joy Konigsberg, PSY.D.
- Clinical Psychologist
- Brooklyn, NY
National Provider Identifier
1295953370
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 015820-01
- Practice address
- 630 Flushing Ave FL 3
Brooklyn, NY 11206-5026 - Phone
- (917) 304-3699
- NPI assigned
- Apr 23, 2007
- Sex
- Female
- 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 | 015820-01 | NY | Primary |
Addresses
Primary practice location
630 Flushing Ave FL 3
Brooklyn, NY 11206-5026
Mailing address
630 Flushing Ave FL 3
Brooklyn, NY 11206-5026
Phone (917) 304-3699
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 02519340 | Medicaid | NY | |
| P3136879 | Other | NY | OXFORD |
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 |
|---|---|---|---|
| 015820 | NY | MD | Mental Health Counselor |
| 015820-01 | NY | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1177286400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1579132800000",
"number": "1295953370",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "630 FLUSHING AVE FL 3",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112065026",
"telephone_number": "917-304-3699"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "630 FLUSHING AVE FL 3",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112065026",
"telephone_number": "917-304-3699"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KONIGSBERG",
"first_name": "MELINDA",
"middle_name": "JOY",
"credential": "PSY.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-04-23",
"last_updated": "2020-01-16",
"certification_date": "2020-01-16",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "NY",
"license": "015820-01",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "02519340",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "OXFORD",
"identifier": "P3136879",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Brooklyn, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.