Organization Active NPI

Westchester Geriatric Psychological Services PC

  • Clinical Psychologist
  • Port Chester, NY
National Provider Identifier
1487976742
Registry record updated May 13, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
016488 Issued in NY
Legal business name
WESTCHESTER GERIATRIC PSYCHOLOGICAL SERVICES PC
Practice address
112 Betsy Brown Rd
Port Chester, NY 10573-2231
Phone
(914) 937-6174
Fax
(914) 937-6174
NPI assigned
Feb 26, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 13, 2014

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

Authorized official

Name
Dr. Timothy W Welles, ED.D.
Title
President
Phone
(914) 937-6174

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103TC0700X 016488 NY Primary

Addresses

Primary practice location

112 Betsy Brown Rd
Port Chester, NY 10573-2231

Mailing address

112 Betsy Brown Rd
Port Chester, NY 10573-2231
Phone (914) 937-6174

National Provider Directory

National Provider Directory

Locations

300 Amsterdam Ave
New York, NY 10023
Phone (212) 595-8983

NPI Registry JSON

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

{
    "created_epoch": "1267142400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1399939200000",
    "number": "1487976742",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "112 BETSY BROWN RD",
            "city": "PORT CHESTER",
            "state": "NY",
            "postal_code": "105732231",
            "telephone_number": "914-937-6174",
            "fax_number": "914-937-6174"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "112 BETSY BROWN RD",
            "city": "PORT CHESTER",
            "state": "NY",
            "postal_code": "105732231",
            "telephone_number": "914-937-6174",
            "fax_number": "914-937-6174"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WESTCHESTER GERIATRIC PSYCHOLOGICAL SERVICES PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-02-26",
        "last_updated": "2014-05-13",
        "status": "A",
        "authorized_official_last_name": "WELLES",
        "authorized_official_first_name": "TIMOTHY",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "914-937-6174",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "ED.D."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "016488",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Chester, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 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.