NPIMap

Organization Active NPI

Intentional Living Psychological Services, PLLC

Doing business as Intentional Living

  • Cognitive & Behavioral Psychologist
  • New York, NY
National Provider Identifier
1497154298
Registry record updated Aug 18, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cognitive & Behavioral PsychologistTaxonomy code 103TB0200X
License
015554 Issued in NY
Legal business name
INTENTIONAL LIVING PSYCHOLOGICAL SERVICES, PLLC
Doing business as
Intentional Living
Practice address
875 Sixth Avenue
Suite 1603
New York, NY 10001-3574
Phone
(646) 478-7682
NPI assigned
Aug 18, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 18, 2014

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

Authorized official

Name
Dr. Stephen Terracciano, PH.D.NPI 1508979303
Title
Director/Psychologist
Phone
(646) 478-7682

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cognitive & Behavioral PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103TB0200X 015554 NY Primary

Addresses

Primary practice location

875 Sixth Avenue
Suite 1603
New York, NY 10001-3574

Mailing address

875 Sixth Avenue
Suite 1603
New York, NY 10001-3574
Phone (646) 478-7682

Other names 1

  • Intentional Living Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1408320000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1408320000000",
    "number": "1497154298",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "875 SIXTH AVENUE",
            "address_2": "SUITE 1603",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100013574",
            "telephone_number": "646-478-7682"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "875 SIXTH AVENUE",
            "address_2": "SUITE 1603",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100013574",
            "telephone_number": "646-478-7682"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTENTIONAL LIVING PSYCHOLOGICAL SERVICES, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-08-18",
        "last_updated": "2014-08-18",
        "status": "A",
        "authorized_official_last_name": "TERRACCIANO",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_title_or_position": "DIRECTOR/PSYCHOLOGIST",
        "authorized_official_telephone_number": "646-478-7682",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103TB0200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Cognitive & Behavioral",
            "state": "NY",
            "license": "015554",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Intentional Living",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Aug 18, 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.