Individual provider Active NPI

Saidah Chambers, PH.D.

  • Clinical Psychologist
  • New York, NY
National Provider Identifier
1366093965
Registry record updated May 17, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
023385 Issued in NY
Practice address
185 Madison Ave
14TH FL, Ste 9
New York, NY 10016-4325
Phone
(929) 266-5018
NPI assigned
Sep 25, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 17, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103TC0700X 023385 NY Primary

Addresses

Primary practice location

185 Madison Ave
14TH FL, Ste 9
New York, NY 10016-4325

Mailing address

13844C Queens Blvd Ste 330
Briarwood, NY 11435-2642
Phone (929) 266-5018

Other practice location 1

185 Madison Ave
14th fl, Ste 9
New York, NY 10016-4325
Phone (929) 266-5018

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
023385NYMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
New Realizations Psychological Services Clinical CurrentSince Apr 26, 2020 Accepting new patients

Locations

13844C Queens Blvd
Briarwood, NY 11435
Phone (404) 388-6686

185 Madison Ave
Fl 14
New York, NY 10016
Phone (212) 506-5935

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1569369600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1589673600000",
    "number": "1366093965",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13844C QUEENS BLVD STE 330",
            "city": "BRIARWOOD",
            "state": "NY",
            "postal_code": "114352642",
            "telephone_number": "929-266-5018"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "185 MADISON AVE",
            "address_2": "14TH FL, STE 9",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100164325",
            "telephone_number": "929-266-5018"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "185 Madison Ave",
            "address_2": "14th fl, Ste 9",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100164325",
            "country_code": "US",
            "telephone_number": "929-266-5018",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHAMBERS",
        "first_name": "SAIDAH",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-09-25",
        "last_updated": "2020-05-17",
        "certification_date": "2020-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "023385",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.