Active NPI
Stephen Russell Anderson, PH.D.
- Clinical Psychologist
- East Amherst, NY
National Provider Identifier
1366680696
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- #012484 DUP
- Practice address
- 8297 Old Post Rd E
East Amherst, NY 14051-1530 - Phone
- (716) 741-3477
- NPI assigned
- Jan 23, 2009
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Analyst | 103K00000X | 1-00-0220 | NY | |
| Clinical Psychologist | 103TC0700X | #012484 DUP | NY | Primary |
Addresses
Primary practice location
8297 Old Post Rd E
East Amherst, NY 14051-1530
Mailing address
8297 Old Post Rd E
East Amherst, NY 14051-1530
Phone (716) 741-3477
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
| License | State | Type | Specialty |
|---|---|---|---|
| #012484 DUP | NY | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1232668800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1232668800000",
"number": "1366680696",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8297 OLD POST RD E",
"city": "EAST AMHERST",
"state": "NY",
"postal_code": "140511530",
"telephone_number": "716-741-3477"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8297 OLD POST RD E",
"city": "EAST AMHERST",
"state": "NY",
"postal_code": "140511530",
"telephone_number": "716-741-3477"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ANDERSON",
"first_name": "STEPHEN",
"middle_name": "RUSSELL",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2009-01-23",
"last_updated": "2009-01-23",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "NY",
"license": "1-00-0220",
"primary": false
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "NY",
"license": "#012484 DUP",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in East Amherst, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.