Life Changing Psychological Services,PLLC

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

0154791 Issued in NY

Legal business name

LIFE CHANGING PSYCHOLOGICAL SERVICES,PLLC

Practice address

153 Main St
Mount Kisco, NY 10549-2317

Phone

(914) 961-8412

NPI assigned

May 21, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Penni Nicole Waldman, PH.D.NPI 1467407015

Title

Psychologist

Phone

(914) 961-8412

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Penni Nicole Waldman, PH.D.

  • Clinical Psychologist
  • Mount Kisco, NY
  • NPI 1467407015
  NPD (past) Authorized official

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

{
    "created_epoch": "1148169600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1459987200000",
    "number": "1497709588",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 215",
            "city": "HARTSDALE",
            "state": "NY",
            "postal_code": "105300215",
            "telephone_number": "914-961-8412",
            "fax_number": "914-961-8412"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "153 MAIN ST",
            "city": "MOUNT KISCO",
            "state": "NY",
            "postal_code": "105492317",
            "telephone_number": "914-961-8412"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFE CHANGING PSYCHOLOGICAL SERVICES,PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-21",
        "last_updated": "2016-04-07",
        "status": "A",
        "authorized_official_last_name": "WALDMAN",
        "authorized_official_first_name": "PENNI",
        "authorized_official_middle_name": "NICOLE",
        "authorized_official_title_or_position": "PSYCHOLOGIST",
        "authorized_official_telephone_number": "914-961-8412",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "0154791",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "WGW281",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Georgina Leylegian, M.D.
• Hsin Ting Li, DO
• Sherry Liao
• Mark Lieb, MD
• Benn Larkin Lieberman, DMD
• Teresa Lim
• Sharon Elizabeth Lind, RN
• Cynthia Linde, PSY.D.
• Nancy Lindig
• Virna Lisi-Demartino, MD

• Clinical Psychologist in Mount Kisco, NY
• Providers in Mount Kisco, NY by specialty
• Clinical Psychologist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2016; 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.