NPIMap

Organization Active NPI

Brian L. Fast, Psy.D. and Stephen P. Greggo, Psy.D, Psychologists, P.C

  • Counseling Psychologist
  • Delmar, NY
National Provider Identifier
1447280581
Registry record updated Jun 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Counseling PsychologistTaxonomy code 103TC1900X
Legal business name
BRIAN L. FAST, PSY.D. AND STEPHEN P. GREGGO, PSY.D, PSYCHOLOGISTS, P.C
Practice address
196 Delaware Ave
Delmar, NY 12054-1227
Phone
(518) 439-0033
Fax
(518) 439-7167
NPI assigned
Jul 4, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2020

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

Authorized official

Name
Mrs. Jill Koonz
Title
Office Manager
Phone
(518) 439-0033

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counseling PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103TC1900X Primary

Addresses

Primary practice location

196 Delaware Ave
Delmar, NY 12054-1227

Mailing address

29 Jay Unit 1067
Schenectady, NY 12301-3307
Phone (518) 374-7555

Other identifiers 1

IdentifierTypeStateIssuer
01727095MedicaidNY

Other names 1

  • Capital Area Christian Counseling Asso Doing business as

National Provider Directory

National Provider Directory

Locations

29 Jay
Unit 1067
Schenectady, NY 12301

Practitioners & affiliated clinicians

Practitioners 20

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 20

NPI Registry JSON

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

{
    "created_epoch": "1151971200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1591747200000",
    "number": "1447280581",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29 JAY UNIT 1067",
            "city": "SCHENECTADY",
            "state": "NY",
            "postal_code": "123013307",
            "telephone_number": "518-374-7555",
            "fax_number": "518-374-6898"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "196 DELAWARE AVE",
            "city": "DELMAR",
            "state": "NY",
            "postal_code": "120541227",
            "telephone_number": "518-439-0033",
            "fax_number": "518-439-7167"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRIAN L. FAST, PSY.D. AND STEPHEN P. GREGGO, PSY.D, PSYCHOLOGISTS, P.C",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-04",
        "last_updated": "2020-06-10",
        "certification_date": "2020-06-10",
        "status": "A",
        "authorized_official_last_name": "KOONZ",
        "authorized_official_first_name": "JILL",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "518-439-0033",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "103TC1900X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Counseling",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01727095",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Capital Area Christian Counseling Asso",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Capital Area Christian Counseling Asso",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Delmar, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2020; 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.