Charles J. Corliss, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

008791-1 Issued in NY

Practice address

425 E 86TH St
Suite 1D
New York, NY 10028-6449

Phone

(212) 410-0499

Fax

(212) 567-9476

NPI assigned

Dec 27, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Fordham University School of Medicine, 1986

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Inwood Community Services, IncGroup PAC ID 1850608100, 6 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Locations

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.

• Inwood Community Services, Inc.

  • Community/Behavioral Health Agency
  • New York, NY
  • NPI 1083771232
  Medicare reassignment Care Compare group NPD Authorized official

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

{
    "created_epoch": "1167177600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1396801346",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "425 E 86TH ST",
            "address_2": "SUITE 1D",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100286449",
            "telephone_number": "212-410-0499",
            "fax_number": "212-567-9476"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "425 E 86TH ST",
            "address_2": "SUITE 1D",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100286449",
            "telephone_number": "212-410-0499",
            "fax_number": "212-567-9476"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORLISS",
        "first_name": "CHARLES",
        "middle_name": "J.",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "008791-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rosemarie Corless, PNP
• Jessica Corletto, N.P.
• Alexandra Marie Corley, RN
• Charles Ian Corley, L.M.H.C.
• Elizabeth Mae Corley, M.D.
• Beth H Corman, DC
• Andre Cormerais
• Beatrice Cormier, MD
• Jacqueline Eileen Cormier, MS OT
• Beth E Corn, 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 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.