Phoenix Psychological Services, P.C.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

016368 Issued in NY

Legal business name

PHOENIX PSYCHOLOGICAL SERVICES, P.C.

Practice address

1865 Amsterdam Ave
New York, NY 10031-1716

Phone

(323) 497-0980

NPI assigned

Jul 18, 2017

Organization subpart

No

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

Authorized official

Name

Dr. Brickell Quarles, PH.D.NPI 1801092770

Title

Owner

Phone

(323) 497-0980

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Practitioners 3

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

• Brickell Quarles, PH.D.

  • Clinical Psychologist
  • Jackson Heights, NY
  • NPI 1801092770
  Medicare reassignment NPD Authorized official
• Victor Brown, LCSW

  • Social Worker
  • New York, NY
  • NPI 1447419874
  Medicare reassignment NPD
• Gisella Patricia Tavarez, LMHC

  • Mental Health Counselor
  • New York, NY
  • NPI 1669060646

  Single Specialty

  NPD (past)

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

{
    "created_epoch": "1500336000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1500336000000",
    "number": "1346763752",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "725 RIVER RD STE 32-110",
            "city": "EDGEWATER",
            "state": "NJ",
            "postal_code": "070201171",
            "telephone_number": "323-497-0980"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1865 AMSTERDAM AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100311716",
            "telephone_number": "323-497-0980"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHOENIX PSYCHOLOGICAL SERVICES, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-07-18",
        "last_updated": "2017-07-18",
        "status": "A",
        "authorized_official_last_name": "QUARLES",
        "authorized_official_first_name": "BRICKELL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "323-497-0980",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "016368",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02898915",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Veronica Phipps
• Phoenix House Foundation
• Phoenix House Foundation, Inc.
• Phoenix Houses of New York, Inc.
• Phoenix Marriage & Family Therapy PLLC
• Phoenixcare Acupuncture & Physical Therapy PC
• Veerawat Phongtankuel, M.D.
• Colin Phoon, M.D.
• Phumlarp Phoromyen, LAC
• Punyadech Photangtham, MD

• Clinical Psychologist in New York, NY
• Providers in New York, NY by specialty
• Clinical Psychologist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 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.