NPIMap

Organization Active NPI

Northeast Psychological Associates PLLC

  • Psychologist
  • Albany, NY
National Provider Identifier
1447817093
Registry record updated May 20, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
Legal business name
NORTHEAST PSYCHOLOGICAL ASSOCIATES PLLC
Practice address
435 New Karner Rd
Albany, NY 12205-3867
Phone
(518) 456-2060
Fax
(518) 456-2361
NPI assigned
May 20, 2019
Last updated
May 20, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 20, 2019

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

Authorized official

Name
Dr. Michael P Dobbin, PSY.D.NPI 1801129176
Title
Sole Owner
Phone
(518) 456-2060

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X Primary
Clinical Social Worker 1041C0700X

Addresses

Primary practice location

435 New Karner Rd
Albany, NY 12205-3867

Mailing address

435 New Karner Rd
Albany, NY 12205-3867
Phone (518) 456-2060

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190624002689 NY Part B Supplier - Clinic/Group Practice 4688908791 Receives reassigned benefits from 11 practitioners
Practice locations: Albany, NY

National Provider Directory

National Provider Directory

Locations

435 New Karner Rd
Albany, NY 12205
Phone (518) 456-1622

Practitioners & affiliated clinicians

Practitioners 32

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.

View all 32

NPI Registry JSON

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

{
    "created_epoch": "1558310400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1558310400000",
    "number": "1447817093",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "435 NEW KARNER RD",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122053867",
            "telephone_number": "518-456-2060",
            "fax_number": "518-456-2361"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "435 NEW KARNER RD",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122053867",
            "telephone_number": "518-456-2060",
            "fax_number": "518-456-2361"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHEAST PSYCHOLOGICAL ASSOCIATES PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-05-20",
        "last_updated": "2019-05-20",
        "status": "A",
        "authorized_official_last_name": "DOBBIN",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "SOLE OWNER",
        "authorized_official_telephone_number": "518-456-2060",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSY.D."
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Albany, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2019; 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.