Active NPI
Melissa Crouch Chang
- Clinical Psychologist
- White Plains, NY
National Provider Identifier
1750316667
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 015888-1
- Practice address
- 3 Barker Ave
Park Avenue Medical Associates PC 4TH Floor
White Plains, NY 10601-1509 - Phone
- (914) 949-1199
- Fax
- (914) 949-1245
- NPI assigned
- Jul 11, 2006
- 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 | 015888-1 | NY | Primary |
Addresses
Primary practice location
3 Barker Ave
Park Avenue Medical Associates PC 4TH Floor
White Plains, NY 10601-1509
Mailing address
3 Barker Ave
Park Avenue Medical Associates PC 4TH Floor
White Plains, NY 10601-1509
Phone (914) 949-1199
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 02694457 | 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 |
|---|---|---|---|
| 015888-1 | NY | MD | Clinical Psychologist |
| 002637 | CT | MD | Medical Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152576000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1750316667",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3 BARKER AVE",
"address_2": "PARK AVENUE MEDICAL ASSOCIATES PC 4TH FLOOR",
"city": "WHITE PLAINS",
"state": "NY",
"postal_code": "106011509",
"telephone_number": "914-949-1199",
"fax_number": "914-949-1245"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3 BARKER AVE",
"address_2": "PARK AVENUE MEDICAL ASSOCIATES PC 4TH FLOOR",
"city": "WHITE PLAINS",
"state": "NY",
"postal_code": "106011509",
"telephone_number": "914-949-1199",
"fax_number": "914-949-1245"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHANG",
"first_name": "MELISSA",
"middle_name": "CROUCH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-07-11",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "NY",
"license": "015888-1",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "02694457",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in White Plains, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.