Individual provider Active NPI

Lawrence Dana, PHD

  • Clinical Psychologist
  • Albany, NY
National Provider Identifier
1790700847
Registry record updated Jan 17, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
4177 Issued in NY
Practice address
4 Central Ave
Albany, NY 12210-1334
Phone
(800) 275-3243
Fax
(800) 275-3671
NPI assigned
Jul 12, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 17, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 4177 NY Primary

Addresses

Primary practice location

4 Central Ave
Albany, NY 12210-1334

Mailing address

4 Central Ave
Albany, NY 12210-1334
Phone (800) 275-3243

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20110225000363 NY Practitioner - Clinical Psychologist 9739360645 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1971
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Nysarc Inc Fulton County Chapter 27 clinicians

Practice addresses (Care Compare)

465 N Perry St
Johnstown, NY 12095-1014
Phone (518) 736-3937

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
4177NYMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Nysarc Inc Fulton County Chapter CurrentSince Jan 1, 2024 Accepting new patients
Achieve Physical Therapy Services of New York PLLC Past Accepting new patients

Locations

127 E State St
Gloversville, NY 12078
Phone (518) 773-7931

465 N Perry St
Johnstown, NY 12095
Phone (518) 736-3937

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1152662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1200528000000",
    "number": "1790700847",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 CENTRAL AVE",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122101334",
            "telephone_number": "800-275-3243",
            "fax_number": "800-275-3671"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 CENTRAL AVE",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122101334",
            "telephone_number": "800-275-3243",
            "fax_number": "800-275-3671"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DANA",
        "first_name": "LAWRENCE",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-12",
        "last_updated": "2008-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "4177",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Albany, NY

Sources for this page

Verify at the official NPI Registry.