Individual provider Active NPI

Stacy Kurtz, PSY.D.

  • Clinical Psychologist
  • Garden City, NY
National Provider Identifier
1679917629
Registry record updated Jan 31, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
021234 Issued in NY
Practice address
1044 Franklin Ave
Suite 206
Garden City, NY 11530-2938
Phone
(516) 234-6794
NPI assigned
Apr 22, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 31, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 021234 NY Primary

Addresses

Primary practice location

1044 Franklin Ave
Suite 206
Garden City, NY 11530-2938

Mailing address

1044 Franklin Ave
Suite 206
Garden City, NY 11530-2938
Phone (516) 234-6794

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

LicenseStateTypeSpecialty
021234NYMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1366588800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1485820800000",
    "number": "1679917629",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1044 FRANKLIN AVE",
            "address_2": "SUITE 206",
            "city": "GARDEN CITY",
            "state": "NY",
            "postal_code": "115302938",
            "telephone_number": "516-234-6794"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1044 FRANKLIN AVE",
            "address_2": "SUITE 206",
            "city": "GARDEN CITY",
            "state": "NY",
            "postal_code": "115302938",
            "telephone_number": "516-234-6794"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KURTZ",
        "first_name": "STACY",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-04-22",
        "last_updated": "2017-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "021234",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Garden City, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2017; 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.