Organization Active NPI

Modern Psychological Services, PLLC

  • Clinical Psychologist
  • Staten Island, NY
National Provider Identifier
1447000112
Registry record updated Jul 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
Legal business name
MODERN PSYCHOLOGICAL SERVICES, PLLC
Practice address
57 Allen CT
Staten Island, NY 10310-2702
Phone
(347) 838-0403
NPI assigned
Mar 25, 2024
Last updated
Jul 6, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 6, 2025

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

Authorized official

Name
Dr. Ashley Campbell, PSY.D.NPI 1891568424
Title
Owner and Licensed Psychologist
Phone
(347) 838-0403

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X NU
Clinical Psychologist 103TC0700X NU Primary
Forensic Psychologist 103TF0200X NU

Addresses

Primary practice location

57 Allen CT
Staten Island, NY 10310-2702

Mailing address

2248 Broadway # 1681
New York, NY 10024-5805
Phone (347) 838-0403

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1711324800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1751760000000",
    "number": "1447000112",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2248 BROADWAY # 1681",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100245805",
            "telephone_number": "347-838-0403"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "57 ALLEN CT",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103102702",
            "telephone_number": "347-838-0403"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MODERN PSYCHOLOGICAL SERVICES, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-03-25",
        "last_updated": "2025-07-06",
        "certification_date": "2025-07-06",
        "status": "A",
        "authorized_official_last_name": "CAMPBELL",
        "authorized_official_first_name": "ASHLEY",
        "authorized_official_title_or_position": "OWNER AND LICENSED PSYCHOLOGIST",
        "authorized_official_telephone_number": "347-838-0403",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSY.D."
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "103TF0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Forensic",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Staten Island, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 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.