Individual provider Active NPI

Michael A Fenichel, PH.D.

  • Psychologist
  • New York, NY
National Provider Identifier
1407078769
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
009149 Issued in NY
Practice address
305 West 72ND Street
Suite # 8C
New York, NY 10023-2678
Phone
(212) 580-0456
Fax
(212) 580-0456
NPI assigned
May 3, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 009149-1 NY
Psychologist 103T00000X 009149 NY Primary

Addresses

Primary practice location

305 West 72ND Street
Suite # 8C
New York, NY 10023-2678

Mailing address

305 West 72ND Street
Suite # 8C
New York, NY 10023-2678
Phone (212) 580-0456

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

LicenseStateTypeSpecialty
009149-1NYMDOccupational Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1178150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1407078769",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "305 WEST 72ND STREET",
            "address_2": "SUITE # 8C",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100232678",
            "telephone_number": "212-580-0456",
            "fax_number": "212-580-0456"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "305 WEST 72ND STREET",
            "address_2": "SUITE # 8C",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100232678",
            "telephone_number": "212-580-0456",
            "fax_number": "212-580-0456"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FENICHEL",
        "first_name": "MICHAEL",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-03",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "009149-1",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NY",
            "license": "009149",
            "primary": true
        }
    ],
    "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 Sep 11, 2025; 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.