Active NPI
Kareen Marie Matouk, PH.D.
- Clinical Psychologist
- New York, NY
National Provider Identifier
1548873193
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 024523
- Practice address
- 710 W 168TH St FL 12
New York, NY 10032-3726 - Phone
- (877) 426-5637
- NPI assigned
- Aug 24, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 024523 | NY | Primary |
| Clinical Psychologist | 103TC0700X | P106096 | NY | |
| Clinical Child & Adolescent Psychologist | 103TC2200X | P106096 | NY | |
| Clinical Child & Adolescent Psychologist | 103TC2200X | 024523 | NY |
Addresses
Primary practice location
710 W 168TH St FL 12
New York, NY 10032-3726
Mailing address
5 Columbus Circle
7TH Floor
New York, NY 10019
Other practice location 1
5 Columbus Circle
7th Floor
New York, NY 10019
Phone (212) 305-6001
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
| License | State | Type | Specialty |
|---|---|---|---|
| P106096 | NY | MD | Clinical Child & Adolescent Psychologist |
| 024523 | NY | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1598227200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1642550400000",
"number": "1548873193",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5 COLUMBUS CIRCLE",
"address_2": "7TH FLOOR",
"city": "NEW YORK",
"state": "NY",
"postal_code": "10019"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "710 W 168TH ST FL 12",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100323726",
"telephone_number": "877-426-5637"
}
],
"practiceLocations": [
{
"address_1": "5 Columbus Circle",
"address_2": "7th Floor",
"address_purpose": "LOCATION",
"city": "New York",
"state": "NY",
"postal_code": "10019",
"country_code": "US",
"telephone_number": "212-305-6001",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MATOUK",
"first_name": "KAREEN",
"middle_name": "MARIE",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-08-24",
"last_updated": "2022-01-19",
"certification_date": "2022-01-19",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "NY",
"license": "024523",
"primary": true
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "NY",
"license": "P106096",
"primary": false
},
{
"code": "103TC2200X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical Child & Adolescent",
"state": "NY",
"license": "P106096",
"primary": false
},
{
"code": "103TC2200X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical Child & Adolescent",
"state": "NY",
"license": "024523",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}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 Jan 19, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.