Active NPI
Nicole Teresa Callan, MA
- Psychologist
- Cedarhurst, NY
National Provider Identifier
1407113145
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 445404101
- Practice address
- 124 McGlynn PL
Cedarhurst, NY 11516-2305 - Phone
- (516) 569-3083
- Fax
- (516) 374-1185
- NPI assigned
- Apr 19, 2012
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | 445404101 | NY | Primary |
Addresses
Primary practice location
124 McGlynn PL
Cedarhurst, NY 11516-2305
Mailing address
124 McGlynn PL
Cedarhurst, NY 11516-2305
Phone (516) 569-3083
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
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 445404101 | NY | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1334793600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1334793600000",
"number": "1407113145",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "124 MCGLYNN PL",
"city": "CEDARHURST",
"state": "NY",
"postal_code": "115162305",
"telephone_number": "516-569-3083",
"fax_number": "516-374-1185"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "124 MCGLYNN PL",
"city": "CEDARHURST",
"state": "NY",
"postal_code": "115162305",
"telephone_number": "516-569-3083",
"fax_number": "516-374-1185"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CALLAN",
"first_name": "NICOLE",
"middle_name": "TERESA",
"name_prefix": "Miss",
"credential": "MA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2012-04-19",
"last_updated": "2012-04-19",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "NY",
"license": "445404101",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Cedarhurst, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.