Individual provider Active NPI

William Halsted James, PH.D.

  • Clinical Psychologist
  • Wantagh, NY
National Provider Identifier
1346364163
Registry record updated Aug 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
012478-1 NY Issued in NY
Practice address
3305 Jerusalem Ave Ste 207
Wantagh, NY 11793-2028
Phone
(516) 785-0323
Fax
(516) 785-6026
NPI assigned
Mar 19, 2007
Last updated
Aug 30, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 30, 2024

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 012478-1 NY NY Primary

Addresses

Primary practice location

3305 Jerusalem Ave Ste 207
Wantagh, NY 11793-2028

Mailing address

1512 Wantagh Ave
Wantagh, NY 11793
Phone (516) 785-0323

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
I20090818000032 NY Practitioner - Clinical Psychologist 3173677705 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
South Shore Counseling and Psychological Services, PCGroup PAC ID 5890849434, 11 clinicians

Practice addresses (Care Compare)

3305 Jerusalem Ave
Suite 207
Wantagh, NY 11793-2028
Phone (516) 785-0323

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
012478-1 NYNYMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
South Shore Counseling and Psychological Services P C CurrentSince Dec 1, 2007 Accepting new patients

Locations

217 Merrick Rd
Ste 212
Amityville, NY 11701

1051 Wantagh Ave
Wantagh, NY 11793
Phone (516) 551-9739

3305 Jerusalem Ave
Ste 207
Wantagh, NY 11793
Phone (516) 785-0323

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1174262400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724976000000",
    "number": "1346364163",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1512 WANTAGH AVE",
            "city": "WANTAGH",
            "state": "NY",
            "postal_code": "11793",
            "telephone_number": "516-785-0323",
            "fax_number": "516-785-6026"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3305 JERUSALEM AVE STE 207",
            "city": "WANTAGH",
            "state": "NY",
            "postal_code": "117932028",
            "telephone_number": "516-785-0323",
            "fax_number": "516-785-6026"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAMES",
        "first_name": "WILLIAM",
        "middle_name": "HALSTED",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-19",
        "last_updated": "2024-08-30",
        "certification_date": "2024-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "012478-1 NY",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wantagh, NY

Sources for this page

Verify at the official NPI Registry.