Donna K Thiele, PSY.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

017221 Issued in NY

Practice address

321 Dante CT Ste 30
Holbrook, NY 11741-3847

Phone

(631) 542-2885

NPI assigned

Jul 30, 2017

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1501372800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601596800000",
    "number": "1477077691",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "321 DANTE CT STE 30",
            "city": "HOLBROOK",
            "state": "NY",
            "postal_code": "117413847",
            "telephone_number": "631-834-7600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "321 DANTE CT STE 30",
            "city": "HOLBROOK",
            "state": "NY",
            "postal_code": "117413847",
            "telephone_number": "631-542-2885"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THIELE",
        "first_name": "DONNA",
        "middle_name": "K",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-07-30",
        "last_updated": "2020-10-02",
        "certification_date": "2020-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "NY",
            "license": "000057",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "017221",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tariq Dental, PLLC
• Telemental Health and Addiction LLC
• Nicole Christine Tessar, PA-C
• Thomas Testa, CO
• The Stop & Shop Supermarket Company LLC
• Thomas M. Pica, Inc.
• Thomas Spinnato PC
• Barbara Tomeo, RN
• Total Care Speech Therapy PC
• Chelsea Townes-Francis, DDS, MPH

• Clinical Psychologist in Holbrook, NY
• Providers in Holbrook, 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 Oct 2, 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.