Organization Active NPI

Jag Psychology PC

  • Psychologist
  • White Plains, NY
National Provider Identifier
1386948420
Registry record updated Aug 20, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
Legal business name
JAG PSYCHOLOGY PC
Practice address
180 S Broadway Ste 202
White Plains, NY 10605-1820
Phone
(914) 414-2253
Fax
(914) 214-8476
NPI assigned
Jan 4, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 20, 2019

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

Authorized official

Name
Dr. Jennifer Gullesserian Straley, PH.D.NPI 1992986566
Title
Psychologist
Phone
(914) 414-2253

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

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

Addresses

Primary practice location

180 S Broadway Ste 202
White Plains, NY 10605-1820

Mailing address

180 S Broadway Ste 202
White Plains, NY 10605-1820
Phone (914) 414-2253

Other practice location 1

2157 North Ave
Bridgeport, CT 06604-2438
Phone (917) 689-1285

National Provider Directory

National Provider Directory

Locations

180 S Broadway
Ste 202
White Plains, NY 10605
Phone (914) 414-2253

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": "1294099200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1566259200000",
    "number": "1386948420",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "180 S BROADWAY STE 202",
            "city": "WHITE PLAINS",
            "state": "NY",
            "postal_code": "106051820",
            "telephone_number": "914-414-2253",
            "fax_number": "914-214-8476"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "180 S BROADWAY STE 202",
            "city": "WHITE PLAINS",
            "state": "NY",
            "postal_code": "106051820",
            "telephone_number": "914-414-2253",
            "fax_number": "914-214-8476"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2157 North Ave",
            "address_purpose": "LOCATION",
            "city": "Bridgeport",
            "state": "CT",
            "postal_code": "066042438",
            "country_code": "US",
            "telephone_number": "917-689-1285",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "JAG PSYCHOLOGY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-01-04",
        "last_updated": "2019-08-20",
        "status": "A",
        "authorized_official_last_name": "GULLESSERIAN STRALEY",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "PSYCHOLOGIST",
        "authorized_official_telephone_number": "914-414-2253",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in White Plains, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2019; 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.