Active NPI
Faith Lennon, PHD
- Clinical Psychologist
- Port Jefferson, NY
National Provider Identifier
1649364787
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 004756-1
- Practice address
- 640 Belle Terre Rd
BLDG. E, Suite 3
Port Jefferson, NY 11777-1936 - Phone
- (631) 473-0996
- NPI assigned
- Oct 3, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 004756-1 | NY | Primary |
Addresses
Primary practice location
640 Belle Terre Rd
BLDG. E, Suite 3
Port Jefferson, NY 11777-1936
Mailing address
640 Belle Terre Rd
BLDG. E, Suite 3
Port Jefferson, NY 11777-1936
Phone (631) 473-0996
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20101223000186 | NY | Practitioner - Clinical Psychologist | 7719175389 | Practice locations: Port Jefferson, NY |
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Psychologist
- Education
- Other, 1974
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
Practice addresses (Care Compare)
5 Settlers Path
Port Jefferson, NY 11777-1413
Phone (631) 473-0996
640 Bell Terre Rd
Port Jefferson, NY 11777-1936
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 004756-1 | NY | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159833600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1649364787",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "640 BELLE TERRE RD",
"address_2": "BLDG. E, SUITE 3",
"city": "PORT JEFFERSON",
"state": "NY",
"postal_code": "117771936",
"telephone_number": "631-473-0996"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "640 BELLE TERRE RD",
"address_2": "BLDG. E, SUITE 3",
"city": "PORT JEFFERSON",
"state": "NY",
"postal_code": "117771936",
"telephone_number": "631-473-0996"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LENNON",
"first_name": "FAITH",
"name_prefix": "Dr.",
"credential": "PHD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-10-03",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "NY",
"license": "004756-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Port Jefferson, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.