Colleen M. Pearson PSYD PLLC

Primary specialty

PsychologistTaxonomy code 103T00000X

License

PY8796 Issued in FL

Legal business name

COLLEEN M. PEARSON PSYD PLLC

Practice address

165 Broadway FL 23
New York, NY 10006-1452

Phone

(917) 725-4774

Fax

(917) 725-8676

NPI assigned

Nov 2, 2016

Last updated

Jun 22, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Colleen Pearson, PSYDNPI 1013223874

Title

Psychologist

Phone

(917) 993-3975

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Colleen M. Pearson, PSY.D.

  • Clinical Psychologist
  • Fort Lauderdale, FL
  • NPI 1013223874

  NY

  Medicare reassignment Authorized official

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

{
    "created_epoch": "1478044800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1624320000000",
    "number": "1407308760",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "630 VICTORY BLVD APT 6E",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103013523",
            "telephone_number": "917-725-4774",
            "fax_number": "917-725-8676"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "165 BROADWAY FL 23",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100061452",
            "telephone_number": "917-725-4774",
            "fax_number": "917-725-8676"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2598 E Sunrise Blvd Ste 210A",
            "address_purpose": "LOCATION",
            "city": "Fort Lauderdale",
            "state": "FL",
            "postal_code": "333043230",
            "country_code": "US",
            "telephone_number": "917-725-4774",
            "fax_number": "917-725-8676",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "COLLEEN M. PEARSON PSYD PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-11-02",
        "last_updated": "2021-06-22",
        "certification_date": "2021-06-22",
        "status": "A",
        "authorized_official_last_name": "PEARSON",
        "authorized_official_first_name": "COLLEEN",
        "authorized_official_title_or_position": "PSYCHOLOGIST",
        "authorized_official_telephone_number": "917-993-3975",
        "authorized_official_credential": "PSYD"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "FL",
            "license": "PY8796",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Selena Collazo
• Stephanie Collazo, LMSW
• Yasmin Collazo, M.D.
• Collective Primary Care Manhattan
• Colleen Cournot DDS & Jenny M. Lee DDS, PLLC
• Abigail Collen, MS, RD, CDN
• Richard Collens, M.D.
• Barry S. Coller, M.D.
• Carlos Collet
• David Thomas Collett, NP

• Psychologist in New York, NY
• Providers in New York, NY by specialty
• Psychologist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.