Active NPI
Alysa Macmillen, PSYD
- Clinical Psychologist
- Henrietta, NY
National Provider Identifier
1679201909
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 024738
- Practice address
- 3045 E Henrietta Rd
Henrietta, NY 14467-9300 - Phone
- (585) 506-6520
- NPI assigned
- Aug 14, 2022
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Cognitive & Behavioral Psychologist | 103TB0200X | 024738 | NY | |
| Clinical Psychologist | 103TC0700X | 024738 | NY | Primary |
Addresses
Primary practice location
3045 E Henrietta Rd
Henrietta, NY 14467-9300
Mailing address
3045 E Henrietta Rd
Henrietta, NY 14467-9300
Phone (585) 506-6520
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
| License | State | Type | Specialty |
|---|---|---|---|
| 024738 | NY | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1660435200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1660435200000",
"number": "1679201909",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3045 E HENRIETTA RD",
"city": "HENRIETTA",
"state": "NY",
"postal_code": "144679300",
"telephone_number": "585-506-6520"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3045 E HENRIETTA RD",
"city": "HENRIETTA",
"state": "NY",
"postal_code": "144679300",
"telephone_number": "585-506-6520"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MACMILLEN",
"first_name": "ALYSA",
"name_prefix": "Dr.",
"credential": "PSYD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-08-14",
"last_updated": "2022-08-14",
"certification_date": "2022-08-14",
"status": "A"
},
"taxonomies": [
{
"code": "103TB0200X",
"taxonomy_group": "",
"desc": "Psychologist, Cognitive & Behavioral",
"state": "NY",
"license": "024738",
"primary": false
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "NY",
"license": "024738",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Henrietta, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.