Gavin Henderson Taylor, D.CLIN.PSY.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

019877-1 Issued in NY

Practice address

20 Century Hill Dr
Suite 202
Latham, NY 12110-2116

Phone

(518) 785-7283

NPI assigned

Nov 12, 2012

Last updated

Nov 19, 2012By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Capital District Behavioral Health Psychologists PLLCGroup PAC ID 6002914660, 5 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Capital District Behavioral Health Psychologists, PLLC

  • Clinical Psychologist
  • Latham, NY
  • NPI 1215152962
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1352678400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1353283200000",
    "number": "1689918872",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 CENTURY HILL DR",
            "address_2": "SUITE 202",
            "city": "LATHAM",
            "state": "NY",
            "postal_code": "121102116"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 CENTURY HILL DR",
            "address_2": "SUITE 202",
            "city": "LATHAM",
            "state": "NY",
            "postal_code": "121102116",
            "telephone_number": "518-785-7283"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAYLOR",
        "first_name": "GAVIN",
        "middle_name": "HENDERSON",
        "name_prefix": "Dr.",
        "credential": "D.CLIN.PSY.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-11-12",
        "last_updated": "2012-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "019877-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PRACTICE NPI",
            "identifier": "1215152962",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Theodore Talma
• Robert Ashu Tambetakaw, RPH
• Jocelyn P Tameta, DDS
• Thomas Tarasovich
• Lydia Tarr
• Christine Terhune, RN
• Kim Teter, PT
• Seema Sarah Teymouri
• The Optical Shop of Latham, LLC
• Rebecca Theadore

• Clinical Psychologist in Latham, NY
• Providers in Latham, NY by specialty
• Clinical Psychologist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2012; 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.

Verify at the official NPI Registry.