Active NPI
Mia Lee, PSY.D.
- Clinical Psychologist
- New York, NY
National Provider Identifier
1710602271
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 025100
- Practice address
- 5 E 16TH St FL 6
New York, NY 10003-3112 - Phone
- (732) 673-1462
- NPI assigned
- Oct 6, 2022
- 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 |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 025100 | NY | Primary |
Addresses
Primary practice location
5 E 16TH St FL 6
New York, NY 10003-3112
Mailing address
31 Jane St Apt 4D
New York, NY 10014-1978
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
| License | State | Type | Specialty |
|---|---|---|---|
| 025100 | NY | MD | Case Manager/Care Coordinator |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1665014400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1665014400000",
"number": "1710602271",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "31 JANE ST APT 4D",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100141978"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5 E 16TH ST FL 6",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100033112",
"telephone_number": "732-673-1462"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEE",
"first_name": "MIA",
"name_prefix": "Dr.",
"credential": "PSY.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-10-06",
"last_updated": "2022-10-06",
"certification_date": "2022-10-06",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "NY",
"license": "025100",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in New York, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.