Upper East Side Psychology Services P.C.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

015689 Issued in NY

Legal business name

UPPER EAST SIDE PSYCHOLOGY SERVICES P.C.

Practice address

343 E 78TH St
Suite D
New York, NY 10075-1315

Phone

(212) 537-6813

Fax

(212) 655-4459

NPI assigned

Dec 3, 2010

Organization subpart

No

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

Authorized official

Name

Dr. Jacqueline Simon, PSY.D.NPI 1285786483

Title

Ceo

Phone

(212) 537-6813

Specialties & licenses 1

Addresses

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jacqueline Lisa Simon, PSY.D.

  • Clinical Psychologist
  • New York, NY
  • NPI 1285786483
  NPD (past) Authorized official
• Pascal Devir Wolf, PSY.D.

  • Psychologist
  • New York, NY
  • NPI 1750561965
  NPD (past)

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

{
    "created_epoch": "1291334400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1313452800000",
    "number": "1760784243",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1461 A FIRST AVENUE",
            "address_2": "SUITE # 315",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "10075",
            "telephone_number": "212-537-6813",
            "fax_number": "212-655-4459"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "343 E 78TH ST",
            "address_2": "SUITE D",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100751315",
            "telephone_number": "212-537-6813",
            "fax_number": "212-655-4459"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UPPER EAST SIDE PSYCHOLOGY SERVICES P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-12-03",
        "last_updated": "2011-08-16",
        "status": "A",
        "authorized_official_last_name": "SIMON",
        "authorized_official_first_name": "JACQUELINE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "212-537-6813",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSY.D."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "015689",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Psychologist in New York, NY
• Providers in New York, 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 Aug 16, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.