Active NPI
Victoria C. Demos, PH.D.
- Clinical Psychologist
- New York, NY
National Provider Identifier
1396866679
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 010570-1
- Practice address
- 300 Mercer St Apt 3L
New York, NY 10003-6732 - Phone
- (917) 406-2456
- NPI assigned
- Apr 3, 2007
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 010570-1 | NY | Primary |
| Clinical Psychologist | 103TC0700X | 003325 | CT |
Addresses
Primary practice location
300 Mercer St Apt 3L
New York, NY 10003-6732
Mailing address
1559 Post Rd
Fairfield, CT 06824-5933
Phone (917) 406-2456
Other practice location 1
1559 Post Rd
Fairfield, CT 06824-5933
Phone (917) 406-2456
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 |
|---|---|---|---|
| 010570-1 | NY | MD | Speech-Language Pathologist |
| 003325 | CT | MD | Adult Health Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1175558400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1647561600000",
"number": "1396866679",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1559 POST RD",
"city": "FAIRFIELD",
"state": "CT",
"postal_code": "068245933",
"telephone_number": "917-406-2456"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "300 MERCER ST APT 3L",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100036732",
"telephone_number": "917-406-2456"
}
],
"practiceLocations": [
{
"address_1": "1559 Post Rd",
"address_purpose": "LOCATION",
"city": "Fairfield",
"state": "CT",
"postal_code": "068245933",
"country_code": "US",
"telephone_number": "917-406-2456",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "DEMOS",
"first_name": "VICTORIA",
"middle_name": "C.",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-04-03",
"last_updated": "2022-03-18",
"certification_date": "2022-03-18",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "NY",
"license": "010570-1",
"primary": true
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CT",
"license": "003325",
"primary": false
}
],
"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 Mar 18, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.