Active NPI
Carla J Mazzeo, PH.D.
- Clinical Psychologist
- New Paltz, NY
National Provider Identifier
1689704496
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 015365
- Practice address
- 52 S Manheim Blvd
New Paltz, NY 12561-2406 - Phone
- (845) 255-2259
- NPI assigned
- Mar 7, 2007
- 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 | 015365 | NY | Primary |
Addresses
Primary practice location
52 S Manheim Blvd
New Paltz, NY 12561-2406
Mailing address
52 S Manheim Blvd
New Paltz, NY 12561-2406
Phone (845) 255-2259
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 696751 | Other | NY | MVP INSURANCE |
| P2819354 | Other | NY | OXFORD INSURANCE |
| 1689704496 | Other | NY | UBH |
| 02393002 | Medicaid | NY |
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)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 015365 | NY | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Aileen Walsh LCSW PC | Past | Accepting new patients | |
| Hollander Psychological Consulting PC | Clinical | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Social Worker
- Woodstock, NY
- NPI 1821585878
-
- Clinical Psychologist
- White Plains, NY
- NPI 1760534481
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1173225600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1253059200000",
"number": "1689704496",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "52 S MANHEIM BLVD",
"city": "NEW PALTZ",
"state": "NY",
"postal_code": "125612406",
"telephone_number": "845-255-2259"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "52 S MANHEIM BLVD",
"city": "NEW PALTZ",
"state": "NY",
"postal_code": "125612406",
"telephone_number": "845-255-2259"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MAZZEO",
"first_name": "CARLA",
"middle_name": "J",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-03-07",
"last_updated": "2009-09-16",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "NY",
"license": "015365",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MVP INSURANCE",
"identifier": "696751",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "OXFORD INSURANCE",
"identifier": "P2819354",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UBH",
"identifier": "1689704496",
"state": "NY"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "02393002",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in New Paltz, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.