Individual provider Active NPI

Sepideh Homayoonfar, PSY.D.

  • Psychologist
  • Great Neck, NY
National Provider Identifier
1578038105
Registry record updated Oct 10, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
022102-01 Issued in NY
Practice address
45 N Station PLZ Ste 206
Great Neck, NY 11021-5031
Phone
(516) 484-1200
NPI assigned
Oct 10, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 10, 2018

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 022102-1 NY
Clinical Child & Adolescent Psychologist 103TC2200X 022102-1 NY
Intellectual & Developmental Disabilities Psychologist 103TM1800X 022102-1 NY
School Psychologist 103TS0200X 022102-1 NY
Psychologist 103T00000X 022102-01 NY Primary

Addresses

Primary practice location

45 N Station PLZ Ste 206
Great Neck, NY 11021-5031

Mailing address

45 N Station PLZ Ste 206
Great Neck, NY 11021-5031
Phone (516) 484-1200

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
022102-01NYMDPsychologist
022102-1NYMDIntellectual & Developmental Disabilities Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1539129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1539129600000",
    "number": "1578038105",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "45 N STATION PLZ STE 206",
            "city": "GREAT NECK",
            "state": "NY",
            "postal_code": "110215031",
            "telephone_number": "516-484-1200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "45 N STATION PLZ STE 206",
            "city": "GREAT NECK",
            "state": "NY",
            "postal_code": "110215031",
            "telephone_number": "516-484-1200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOMAYOONFAR",
        "first_name": "SEPIDEH",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-10-10",
        "last_updated": "2018-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "022102-1",
            "primary": false
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "NY",
            "license": "022102-1",
            "primary": false
        },
        {
            "code": "103TM1800X",
            "taxonomy_group": "",
            "desc": "Psychologist, Intellectual & Developmental Disabilities",
            "state": "NY",
            "license": "022102-1",
            "primary": false
        },
        {
            "code": "103TS0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, School",
            "state": "NY",
            "license": "022102-1",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NY",
            "license": "022102-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Great Neck, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2018; 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.