Individual provider Active NPI

Lauren Waine, PH.D.

  • Clinical Psychologist
  • New York, NY
National Provider Identifier
1790862852
Registry record updated Apr 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
016751 Issued in NY
Practice address
80 5TH Ave RM 903a
New York, NY 10011-7611
Phone
(347) 524-3277
NPI assigned
Nov 1, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 27, 2023

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 016751 NY Primary

Addresses

Primary practice location

80 5TH Ave RM 903a
New York, NY 10011-7611

Mailing address

80 5TH Ave RM 903a
New York, NY 10011-7611
Phone (347) 524-3277

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
I20070518000006 NY Practitioner - Clinical Psychologist 8123125663 Practice locations: New York, NY

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

80 5TH Ave
RM 903a
New York, NY 10011-7611
Phone (347) 524-3277

National Provider Directory

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

NPI Registry JSON

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682553600000",
    "number": "1790862852",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "80 5TH AVE RM 903A",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100117611",
            "telephone_number": "347-524-3277"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "80 5TH AVE RM 903A",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100117611",
            "telephone_number": "347-524-3277"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAINE",
        "first_name": "LAUREN",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-01",
        "last_updated": "2023-04-27",
        "certification_date": "2023-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "016751",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.