Active NPI
Heather Lynne Clare, MA, ADHD-CCSP
- School Psychologist
- Bay Shore, NY
National Provider Identifier
1700666492
On this page
Key facts
NPPES NPI Registry- Primary specialty
- School Psychologist
- License
- 962632
- Practice address
- 795 Wisconsin Ave
Bay Shore, NY 11706-2336 - Phone
- (631) 332-1806
- NPI assigned
- Oct 2, 2023
- Last updated
- Nov 6, 2023
- 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 |
|---|---|---|---|---|
| School Psychologist | 103TS0200X | 962632 | NY | Primary |
Addresses
Primary practice location
795 Wisconsin Ave
Bay Shore, NY 11706-2336
Mailing address
1311 Mill Rd
Ronkonkoma, NY 11779-1402
Phone (631) 332-1806
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
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 962632 | NY | MD | School Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1696204800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1699228800000",
"number": "1700666492",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1311 MILL RD",
"city": "RONKONKOMA",
"state": "NY",
"postal_code": "117791402",
"telephone_number": "631-332-1806"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "795 WISCONSIN AVE",
"city": "BAY SHORE",
"state": "NY",
"postal_code": "117062336",
"telephone_number": "631-332-1806"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CLARE",
"first_name": "HEATHER",
"middle_name": "LYNNE",
"name_prefix": "Ms.",
"credential": "MA, ADHD-CCSP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2023-10-02",
"last_updated": "2023-11-06",
"certification_date": "2023-11-06",
"status": "A"
},
"taxonomies": [
{
"code": "103TS0200X",
"taxonomy_group": "",
"desc": "Psychologist, School",
"state": "NY",
"license": "962632",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bay Shore, NY
- City Medical of Upper East Side, PLLC (CityMD Urgent Care)
- City Medical of Upper East Side, PLLC (Citymd Urgent Care)
- City Medical of Upper East Side, PLLC (CityMD)
- City Medical of Upper East Side, PLLC (Summit Health)
- Joseph Ciufo
- Heather Amy Clark, MA
- Katelyn Rose Clark
- Rebecca N Clark
- Claudia J Selgrad DO PC
- Hilda Mariette Clesidor-Louis
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.