Individual provider Active NPI

January Massin, PH.D.

  • Psychologist
  • New York, NY
National Provider Identifier
1508115189
Registry record updated Aug 29, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
019588 Issued in NY
Practice address
1000 10TH Avenue
8G-45
New York, NY 10019
Phone
(212) 523-5825
Fax
(212) 523-6494
NPI assigned
Aug 29, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 29, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 019588 NY Primary
Clinical Psychologist 103TC0700X 019588 NY

Addresses

Primary practice location

1000 10TH Avenue
8G-45
New York, NY 10019

Mailing address

1000 10TH Avenue
8G-45
New York, NY 10019
Phone (212) 523-5825

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Oct 8, 2021 through Oct 8, 2027

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

NPI Registry JSON

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

{
    "created_epoch": "1346198400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1346198400000",
    "number": "1508115189",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 10TH AVENUE",
            "address_2": "8G-45",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "10019",
            "telephone_number": "212-523-5825",
            "fax_number": "212-523-6494"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 10TH AVENUE",
            "address_2": "8G-45",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "10019",
            "telephone_number": "212-523-5825",
            "fax_number": "212-523-6494"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MASSIN",
        "first_name": "JANUARY",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-08-29",
        "last_updated": "2012-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NY",
            "license": "019588",
            "primary": true
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "019588",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.