Individual provider Active NPI

Rebecca King, PSY.D.

  • Clinical Child & Adolescent Psychologist
  • Larchmont, NY
National Provider Identifier
1558510057
Registry record updated Sep 9, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Child & Adolescent PsychologistTaxonomy code 103TC2200X
License
014828 Issued in NY
Practice address
4 Chatsworth Ave
Larchmont, NY 10538-2946
Phone
(917) 848-8436
NPI assigned
Sep 9, 2008
Last updated
Sep 9, 2008By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 9, 2008

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

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Child & Adolescent Psychologist 103TC2200X 014828 NY Primary
Clinical Child & Adolescent Psychologist 103TC2200X 04364 MD
Clinical Child & Adolescent Psychologist 103TC2200X PSY1000354 DC
Intellectual & Developmental Disabilities Psychologist 103TM1800X PSY1000354 DC
Intellectual & Developmental Disabilities Psychologist 103TM1800X 014828 NY
Intellectual & Developmental Disabilities Psychologist 103TM1800X 04364 MD

Addresses

Primary practice location

4 Chatsworth Ave
Larchmont, NY 10538-2946

Mailing address

4 Chatsworth Ave
Larchmont, NY 10538-2946
Phone (917) 848-8436

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

State licenses

LicenseStateTypeSpecialty
PSY1000354DCMDClinical Child & Adolescent Psychologist
04364MDMDOccupational Therapist
014828NYMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1220918400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1220918400000",
    "number": "1558510057",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 CHATSWORTH AVE",
            "city": "LARCHMONT",
            "state": "NY",
            "postal_code": "105382946",
            "telephone_number": "917-848-8436"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 CHATSWORTH AVE",
            "city": "LARCHMONT",
            "state": "NY",
            "postal_code": "105382946",
            "telephone_number": "917-848-8436"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KING",
        "first_name": "REBECCA",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-09-09",
        "last_updated": "2008-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "NY",
            "license": "014828",
            "primary": true
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "MD",
            "license": "04364",
            "primary": false
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "DC",
            "license": "PSY1000354",
            "primary": false
        },
        {
            "code": "103TM1800X",
            "taxonomy_group": "",
            "desc": "Psychologist, Intellectual & Developmental Disabilities",
            "state": "DC",
            "license": "PSY1000354",
            "primary": false
        },
        {
            "code": "103TM1800X",
            "taxonomy_group": "",
            "desc": "Psychologist, Intellectual & Developmental Disabilities",
            "state": "NY",
            "license": "014828",
            "primary": false
        },
        {
            "code": "103TM1800X",
            "taxonomy_group": "",
            "desc": "Psychologist, Intellectual & Developmental Disabilities",
            "state": "MD",
            "license": "04364",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Larchmont, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2008; 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.