Active NPI
Alisa N Samuels-Stein, PHD
- School Psychologist
- Port Washington, NY
National Provider Identifier
1679841159
On this page
Key facts
NPPES NPI Registry- Primary specialty
- School Psychologist
- License
- 015585-1
- Practice address
- 38 Poplar PL
Port Washington, NY 11050-1858 - Phone
- (516) 767-5250
- NPI assigned
- Dec 12, 2011
- Last updated
- Dec 12, 2011
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| School Psychologist | 103TS0200X | 015585-1 | NY | Primary |
Addresses
Primary practice location
38 Poplar PL
Port Washington, NY 11050-1858
Mailing address
38 Poplar PL
Port Washington, NY 11050-1858
Phone (516) 767-5250
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
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 015585-1 | NY | MD | School Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1323648000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1323648000000",
"number": "1679841159",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "38 POPLAR PL",
"city": "PORT WASHINGTON",
"state": "NY",
"postal_code": "110501858",
"telephone_number": "516-767-5250"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "38 POPLAR PL",
"city": "PORT WASHINGTON",
"state": "NY",
"postal_code": "110501858",
"telephone_number": "516-767-5250"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SAMUELS-STEIN",
"first_name": "ALISA",
"middle_name": "N",
"name_prefix": "Dr.",
"credential": "PHD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-12-12",
"last_updated": "2011-12-12",
"status": "A"
},
"taxonomies": [
{
"code": "103TS0200X",
"taxonomy_group": "",
"desc": "Psychologist, School",
"state": "NY",
"license": "015585-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Port Washington, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.