Individual provider Active NPI

Mary Katrina Smith, PSY.D.

  • Clinical Psychologist
  • Saratoga Springs, NY
National Provider Identifier
1386057784
Registry record updated Jun 4, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
017625-1 Issued in NY
Practice address
401 Geyser Rd
Saratoga Springs, NY 12866-9069
Phone
(518) 583-3035
Fax
(518) 583-4247
NPI assigned
Jun 4, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 4, 2014

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 017625-1 NY Primary

Addresses

Primary practice location

401 Geyser Rd
Saratoga Springs, NY 12866-9069

Mailing address

401 Geyser Rd
Saratoga Springs, NY 12866-9069
Phone (518) 583-3035

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

State licenses

LicenseStateTypeSpecialty
017625-1NYMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Saratoga Psychiatric and Associated Services PC Clinical Past Accepting new patients

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": "1401840000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1401840000000",
    "number": "1386057784",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 GEYSER RD",
            "city": "SARATOGA SPRINGS",
            "state": "NY",
            "postal_code": "128669069",
            "telephone_number": "518-583-3035",
            "fax_number": "518-583-4247"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 GEYSER RD",
            "city": "SARATOGA SPRINGS",
            "state": "NY",
            "postal_code": "128669069",
            "telephone_number": "518-583-3035",
            "fax_number": "518-583-4247"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "MARY KATRINA",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-06-04",
        "last_updated": "2014-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "017625-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saratoga Springs, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2014; 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.