Michael P Homenick, PH.D.

Primary specialty

PsychologistTaxonomy code 103T00000X

License

008202 Issued in NY

Practice address

551 Bay Rd
Queensbury, NY 12804-1441

Phone

(518) 798-4056

Fax

(518) 798-4255

NPI assigned

Dec 28, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Psychological Associates of Northeastern New York PC

  dba Psychological Associates

  • Psychologist
  • Queensbury, NY
  • NPI 1831246792
  Authorized official Same address or phone

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

{
    "created_epoch": "1167264000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1477619252",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "551 BAY RD",
            "city": "QUEENSBURY",
            "state": "NY",
            "postal_code": "128041441",
            "telephone_number": "518-798-4056",
            "fax_number": "518-798-4255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "551 BAY RD",
            "city": "QUEENSBURY",
            "state": "NY",
            "postal_code": "128041441",
            "telephone_number": "518-798-4056",
            "fax_number": "518-798-4255"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOMENICK",
        "first_name": "MICHAEL",
        "middle_name": "P",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-28",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NY",
            "license": "008202",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01035914",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MOHAWK VALLEY PHYSICIANS",
            "identifier": "41136",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "000463033002",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Meghan Hogan
• Robert G Hogan, M.D.
• Alexander Holcomb
• Holly Holman, RN, CLC
• Lilian Holt
• Toni A Homenick
• Christina Marie Hooker, PMHNP
• Suzanne Hotaling
• Catherine Houshower
• Patricia Howard, SCHOOL PSYCHOLOGIST

• Psychologist in Queensbury, NY
• Providers in Queensbury, NY by specialty
• Psychologist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.