Individual provider Active NPI

Peggy Loo, PHD

  • Psychologist
  • New York, NY
National Provider Identifier
1508154352
Registry record updated Mar 1, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
023109 Issued in NY
Practice address
580 Broadway
New York, NY 10012-3223
Phone
(212) 271-0216
NPI assigned
Jul 14, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 1, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 178006354 IL
PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103T00000X 023109 NY Primary

Addresses

Primary practice location

580 Broadway
New York, NY 10012-3223

Mailing address

461 W 150TH St Apt 3a
New York, NY 10031-2729
Phone (630) 363-3517

Other practice location 1

1616 E Roosevelt Rd
Suite 8
Wheaton, IL 60187-6850
Phone (630) 588-1201 ext. 326

Other names 1

  • Dr. Peggy Loo Professional name

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
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
178006354ILMDProfessional Counselor

NPI Registry JSON

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

{
    "created_epoch": "1310601600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1551398400000",
    "number": "1508154352",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "461 W 150TH ST APT 3A",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100312729",
            "telephone_number": "630-363-3517"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "580 BROADWAY",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100123223",
            "telephone_number": "212-271-0216"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1616 E Roosevelt Rd",
            "address_2": "Suite 8",
            "address_purpose": "LOCATION",
            "city": "Wheaton",
            "state": "IL",
            "postal_code": "601876850",
            "country_code": "US",
            "telephone_number": "630-588-1201 x326",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LOO",
        "first_name": "PEGGY",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-07-14",
        "last_updated": "2019-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "178006354",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist",
            "state": "NY",
            "license": "023109",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "PEGGY",
            "last_name": "LOO",
            "prefix": "DR.",
            "credential": "PHD",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

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 Mar 1, 2019; 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.