Nicole Vigoda Gonzalez

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

022932 Issued in NY

Practice address

1 Hunter Ave
Armonk, NY 10504-2025

Phone

(646) 320-6055

NPI assigned

Jul 3, 2014

Last updated

Nov 18, 2020By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1404345600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605657600000",
    "number": "1639585276",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 MILLER CIR",
            "city": "ARMONK",
            "state": "NY",
            "postal_code": "105041357",
            "telephone_number": "646-320-6055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 HUNTER AVE",
            "city": "ARMONK",
            "state": "NY",
            "postal_code": "105042025",
            "telephone_number": "646-320-6055"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VIGODA GONZALEZ",
        "first_name": "NICOLE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-07-03",
        "last_updated": "2020-11-18",
        "certification_date": "2020-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "022932",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PROFESSIONAL LICENCE",
            "identifier": "022932",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Clinical Psychologist in Armonk, NY
• Providers in Armonk, NY by specialty
• Clinical Psychologist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2020; 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.