Individual provider Active NPI

Sandra Mays Clough, PH.D.

  • Clinical Psychologist
  • New York, NY
National Provider Identifier
1306073283
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
0199371 Issued in NY
Practice address
50 Broadway FL 6
New York, NY 10004-3810
Phone
(917) 532-0121
NPI assigned
Jun 17, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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 0199371 NY Primary

Addresses

Primary practice location

50 Broadway FL 6
New York, NY 10004-3810

Mailing address

50 Broadway FL 6
New York, NY 10004-3810
Phone (917) 532-0121

Other practice location 1

10 South Dr
Hastings ON Hudson, NY 10706-1814
Phone (917) 532-0121

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20171220001736 NY Practitioner - Clinical Psychologist 8022376086 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Center for Hearing and CommunicationGroup PAC ID 7911803317, 16 clinicians

Practice addresses (Care Compare)

50 Broadway
FL 6
New York, NY 10004-3810
Phone (917) 305-7700

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
0199371NYMDClinical Psychologist
019937NYMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Center for Hearing and Communication CurrentSince Oct 7, 2017 Accepting new patients
Center for Hearing and Communication Clinical CurrentSince Oct 7, 2017 Accepting new patients

Locations

50 Broadway
Fl 6
New York, NY 10004
Phone (917) 305-7700

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1245196800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1306073283",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50 BROADWAY FL 6",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100043810",
            "telephone_number": "917-532-0121"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 BROADWAY FL 6",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100043810",
            "telephone_number": "917-532-0121"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10 South Dr",
            "address_purpose": "LOCATION",
            "city": "Hastings ON Hudson",
            "state": "NY",
            "postal_code": "107061814",
            "country_code": "US",
            "telephone_number": "917-532-0121",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CLOUGH",
        "first_name": "SANDRA",
        "middle_name": "MAYS",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-06-17",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "0199371",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.