Individual provider Active NPI

Charmaine Andrea Wilkinson- Brown, MS.ED, SPEC.ED

  • Intellectual & Developmental Disabilities Psychologist
  • Valley Stream, NY
National Provider Identifier
1497197784
Registry record updated Jul 26, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual & Developmental Disabilities PsychologistTaxonomy code 103TM1800X
License
71854131 Issued in NY
Practice address
1145 Irving St S
Valley Stream, NY 11580-2340
Phone
(516) 285-0391
NPI assigned
Jul 26, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 26, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual & Developmental Disabilities Psychologist 103TM1800X 71854131 NY Primary

Addresses

Primary practice location

1145 Irving St S
Valley Stream, NY 11580-2340

Mailing address

1145 Irving St S
Valley Stream, NY 11580-2340
Phone (516) 285-0391

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

State licenses

LicenseStateTypeSpecialty
71854131NYMDIntellectual & Developmental Disabilities Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1374796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1374796800000",
    "number": "1497197784",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1145 IRVING ST S",
            "city": "VALLEY STREAM",
            "state": "NY",
            "postal_code": "115802340",
            "telephone_number": "516-285-0391"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1145 IRVING ST S",
            "city": "VALLEY STREAM",
            "state": "NY",
            "postal_code": "115802340",
            "telephone_number": "516-285-0391"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILKINSON- BROWN",
        "first_name": "CHARMAINE",
        "middle_name": "ANDREA",
        "name_prefix": "Mrs.",
        "credential": "MS.ED, SPEC.ED",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-07-26",
        "last_updated": "2013-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TM1800X",
            "taxonomy_group": "",
            "desc": "Psychologist, Intellectual & Developmental Disabilities",
            "state": "NY",
            "license": "71854131",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Valley Stream, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2013; 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.