Active NPI
Jeanne M Sevelius, PHD
- Clinical Psychologist
- New York, NY
National Provider Identifier
1467172320
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 025700
- Practice address
- 722 W 168TH St
New York, NY 10032-3727 - Phone
- (646) 774-6931
- NPI assigned
- Aug 31, 2022
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | PSY26349 | CA | |
| Clinical Psychologist | 103TC0700X | 025700 | NY | Primary |
Addresses
Primary practice location
722 W 168TH St
New York, NY 10032-3727
Mailing address
327 W 11TH St Apt 2E
New York, NY 10014-6221
Phone (510) 703-5990
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PSY26349 | CA | MD | Clinical Psychologist |
| 025700 | NY | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1661904000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1684713600000",
"number": "1467172320",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "327 W 11TH ST APT 2E",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100146221",
"telephone_number": "510-703-5990"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "722 W 168TH ST",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100323727",
"telephone_number": "646-774-6931"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SEVELIUS",
"first_name": "JEANNE",
"middle_name": "M",
"name_prefix": "Dr.",
"credential": "PHD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-08-31",
"last_updated": "2023-05-22",
"certification_date": "2023-05-22",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CA",
"license": "PSY26349",
"primary": false
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "NY",
"license": "025700",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
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Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.