Individual provider Active NPI

Nicole Baum, PSY.D.

  • Clinical Psychologist
  • New York, NY
National Provider Identifier
1639428725
Registry record updated Sep 21, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
024885-01 Issued in NY
Practice address
167 Madison Avenue
Suite 205 #1014
New York, NY 10016-5403
Phone
(201) 734-4104
NPI assigned
Sep 5, 2012
Last updated
Sep 21, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 21, 2026

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 11319 MA
Clinical Psychologist 103TC0700X 024885-01 NY Primary

Addresses

Primary practice location

167 Madison Avenue
Suite 205 #1014
New York, NY 10016-5403

Mailing address

167 Madison Avenue
Suite 205 #1014
New York, NY 10016-5403
Phone (201) 734-4104

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)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1346803200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1789948800000",
    "number": "1639428725",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "167 MADISON AVENUE",
            "address_2": "SUITE 205 #1014",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100165403",
            "telephone_number": "201-734-4104"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "167 MADISON AVENUE",
            "address_2": "SUITE 205 #1014",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100165403",
            "telephone_number": "201-734-4104"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAUM",
        "first_name": "NICOLE",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-09-05",
        "last_updated": "2026-09-21",
        "certification_date": "2026-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MA",
            "license": "11319",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "024885-01",
            "primary": true
        }
    ],
    "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 Sep 21, 2026; 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.