Individual provider Active NPI

Verna Maccornack, PH.D

  • Psychoanalysis Psychologist
  • New York, NY
National Provider Identifier
1790804565
Registry record updated Sep 21, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychoanalysis PsychologistTaxonomy code 103TP0814X
License
6686 Issued in NY
Practice address
120 E 75TH St
New York, NY 10021-3240
Phone
(212) 744-8778
NPI assigned
Mar 29, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 21, 2009

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

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 6686 NY
Adult Development & Aging Psychologist 103TA0700X 6686 NY
Clinical Psychologist 103TC0700X 6686 NY
Psychoanalysis Psychologist 103TP0814X 6686 NY Primary
Psychologist 103T00000X 6686 NY
Marriage & Family Therapist 106H00000X 6686 NY

Addresses

Primary practice location

120 E 75TH St
New York, NY 10021-3240

Mailing address

239 Central Park W
New York, NY 10024-6038
Phone (212) 744-8778

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

Practice roles

OrganizationSpecialtyStatusNew patients
Amy B Lewis MD PC PastSince Sep 4, 2018 Accepting new patients
Amy B Lewis & Associates LLC PastSince Jul 4, 2021 Accepting new patients

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": "1175126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1253491200000",
    "number": "1790804565",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "239 CENTRAL PARK W",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100246038",
            "telephone_number": "212-744-8778"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 E 75TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100213240",
            "telephone_number": "212-744-8778"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACCORNACK",
        "first_name": "VERNA",
        "name_prefix": "Dr.",
        "credential": "PH.D",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-29",
        "last_updated": "2009-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NY",
            "license": "6686",
            "primary": false
        },
        {
            "code": "103TA0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Adult Development & Aging",
            "state": "NY",
            "license": "6686",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "6686",
            "primary": false
        },
        {
            "code": "103TP0814X",
            "taxonomy_group": "",
            "desc": "Psychologist, Psychoanalysis",
            "state": "NY",
            "license": "6686",
            "primary": true
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NY",
            "license": "6686",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "NY",
            "license": "6686",
            "primary": false
        }
    ],
    "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 Sep 21, 2009; 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.