Individual provider Active NPI

Joan Stern, PSY D

  • Psychologist
  • Mamaroneck, NY
National Provider Identifier
1306995600
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
0102642 Issued in NY
Practice address
585 North Barry Avenue
Mamaroneck, NY 10543
Phone
(914) 777-2102
NPI assigned
Jan 9, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 0102642 NY Primary

Addresses

Primary practice location

585 North Barry Avenue
Mamaroneck, NY 10543

Mailing address

585 North Barry Avenue
Mamaroneck, NY 10543
Phone (914) 777-2102

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
I20080702000001 NY Practitioner - Clinical Psychologist 3173695475 Practice locations: Larchmont, NY

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

24 Byron LN
Larchmont, NY 10538-1618
Phone (914) 777-2102

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
010264NYMDMental Health Counselor
0102642NYMDPsychologist

NPI Registry JSON

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

{
    "created_epoch": "1168300800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1306995600",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "585 NORTH BARRY AVENUE",
            "city": "MAMARONECK",
            "state": "NY",
            "postal_code": "10543",
            "telephone_number": "914-777-2102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "585 NORTH BARRY AVENUE",
            "city": "MAMARONECK",
            "state": "NY",
            "postal_code": "10543",
            "telephone_number": "914-777-2102"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STERN",
        "first_name": "JOAN",
        "name_prefix": "Dr.",
        "credential": "PSY D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-09",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NY",
            "license": "0102642",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mamaroneck, NY

Sources for this page

Verify at the official NPI Registry.