Individual provider Active NPI

Joanna Maura Katsigeorgis, LP

  • Clinical Psychologist
  • Dix Hills, NY
National Provider Identifier
1518470145
Registry record updated Mar 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
025541-01 Issued in NY
Practice address
106 Majestic Dr
Dix Hills, NY 11746-4935
Phone
(347) 925-0316
Fax
(347) 925-0316
NPI assigned
Nov 6, 2017
Last updated
Mar 13, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 13, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 40250 TX
Clinical Psychologist 103TC0700X 025541-01 NY Primary

Addresses

Primary practice location

106 Majestic Dr
Dix Hills, NY 11746-4935

Mailing address

106 Majestic Dr
Dix Hills, NY 11746-4935
Phone (347) 925-0316

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230531002818 NY Practitioner - Clinical Psychologist 1456718733 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
025541-01NYMDClinical Psychologist
40250TXMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Charles Evans Center, Inc CurrentSince Mar 12, 2025 Accepting new patients
Senior Care Therapy Psychology of New York PLLC Clinical CurrentSince May 1, 2023 Accepting new patients
Charles Evans Center, Inc CurrentSince Mar 12, 2025 Accepting new patients
Charles Evans Center, Inc. Current Accepting new patients

Locations

2719 Hollywood Blvd
Hollywood, FL 33020
Phone (954) 354-2555

857 S Oyster Bay Rd
Bethpage, NY 11714
Phone (516) 622-8888

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1509926400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741824000000",
    "number": "1518470145",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "106 MAJESTIC DR",
            "city": "DIX HILLS",
            "state": "NY",
            "postal_code": "117464935",
            "telephone_number": "347-925-0316"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "106 MAJESTIC DR",
            "city": "DIX HILLS",
            "state": "NY",
            "postal_code": "117464935",
            "telephone_number": "347-925-0316",
            "fax_number": "347-925-0316"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KATSIGEORGIS",
        "first_name": "JOANNA",
        "middle_name": "MAURA",
        "credential": "LP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-11-06",
        "last_updated": "2025-03-13",
        "certification_date": "2025-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "TX",
            "license": "40250",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "025541-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dix Hills, NY

Sources for this page

Verify at the official NPI Registry.