Constance Ellen Schoenberg, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

011324 Issued in NY

Practice address

1239 N Country Rd
Ste 7
Stony Brook, NY 11790-1934

Phone

(631) 751-4615

Fax

(631) 941-2774

NPI assigned

Jun 13, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1150156800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1393372800000",
    "number": "1457394082",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 E BROADWAY",
            "city": "PORT JEFFERSON",
            "state": "NY",
            "postal_code": "117771248",
            "telephone_number": "631-928-5245",
            "fax_number": "631-941-2774"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1239 N COUNTRY RD",
            "address_2": "STE 7",
            "city": "STONY BROOK",
            "state": "NY",
            "postal_code": "117901934",
            "telephone_number": "631-751-4615",
            "fax_number": "631-941-2774"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHOENBERG",
        "first_name": "CONSTANCE",
        "middle_name": "ELLEN",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-06-13",
        "last_updated": "2014-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "011324",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WORKER'S COMPENSATION",
            "identifier": "S11324",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Eric John Schmalzried, MD
• Jonathon Schmidt, DO
• Tara Nicole Schmidt, PHARMD
• Dawn-Marie Schmitz, N.P.
• Kevin Joseph Schneider, ATS
• Mark Schoenberg, M.D.
• Lauren Hiller Schoenfeld, MSPT
• Matthew Schottenfeld
• Brian F Schrage II, NP
• Rena Schreier, MD

• Clinical Psychologist in Stony Brook, NY
• Providers in Stony Brook, NY by specialty
• Clinical Psychologist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.