Organization Active NPI

Psychological Services of Orange County, P.C.

  • Psychologist
  • Goshen, NY
National Provider Identifier
1346457322
Registry record updated Jun 29, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
4226 Issued in NY
Legal business name
PSYCHOLOGICAL SERVICES OF ORANGE COUNTY, P.C.
Practice address
28 McBride Place
Goshen, NY 10924-2107
Phone
(845) 294-8741
Fax
(845) 294-5337
NPI assigned
May 17, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 29, 2017

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

Authorized official

Name
Thomas Francis Kennedy, PH.D.
Title
Preident
Phone
(845) 294-8741

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103T00000X 4226 NY Primary

Addresses

Primary practice location

28 McBride Place
Goshen, NY 10924-2107

Mailing address

PO Box 841
28 McBride Place
Goshen, NY 10924-0841
Phone (845) 294-8741

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040312000991 NY Part B Supplier - Clinic/Group Practice 4082503420 Receives reassigned benefits from 1 practitioner
Practice locations: Goshen, NY

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1179360000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1498694400000",
    "number": "1346457322",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 841",
            "address_2": "28 MCBRIDE PLACE",
            "city": "GOSHEN",
            "state": "NY",
            "postal_code": "109240841",
            "telephone_number": "845-294-8741",
            "fax_number": "845-294-5337"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28 MCBRIDE PLACE",
            "city": "GOSHEN",
            "state": "NY",
            "postal_code": "109242107",
            "telephone_number": "845-294-8741",
            "fax_number": "845-294-5337"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PSYCHOLOGICAL SERVICES OF ORANGE COUNTY, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-17",
        "last_updated": "2017-06-29",
        "status": "A",
        "authorized_official_last_name": "KENNEDY",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "FRANCIS",
        "authorized_official_title_or_position": "PREIDENT",
        "authorized_official_telephone_number": "845-294-8741",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist",
            "state": "NY",
            "license": "4226",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Goshen, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.