Individual provider Active NPI

Monica L. Creelman, PH.D.

  • Psychologist
  • New York, NY
National Provider Identifier
1477950624
Registry record updated Dec 2, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
014921-1 Issued in NY
Practice address
560 Broadway RM 510
New York, NY 10012-3946
Phone
(212) 924-8937
Fax
(212) 924-8937
NPI assigned
Dec 2, 2014
Last updated
Dec 2, 2014By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 2, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Neuropsychologist 103G00000X 014921-1 NY
Psychologist 103T00000X 014921-1 NY Primary

Addresses

Primary practice location

560 Broadway RM 510
New York, NY 10012-3946

Mailing address

560 Broadway RM 510
New York, NY 10012-3946
Phone (212) 924-8937

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

LicenseStateTypeSpecialty
014921-1NYMDClinical Neuropsychologist

NPI Registry JSON

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

{
    "created_epoch": "1417478400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1417478400000",
    "number": "1477950624",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "560 BROADWAY RM 510",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100123946",
            "telephone_number": "212-924-8937",
            "fax_number": "212-924-8937"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "560 BROADWAY RM 510",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100123946",
            "telephone_number": "212-924-8937",
            "fax_number": "212-924-8937"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CREELMAN",
        "first_name": "MONICA",
        "middle_name": "L.",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-12-02",
        "last_updated": "2014-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "NY",
            "license": "014921-1",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NY",
            "license": "014921-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2014; 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.