Edward Joseph Schork Jr., PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

001636 Issued in CT

Practice address

523 E Putnam Ave
Suite 24
Greenwich, CT 06830-4877

Phone

(203) 448-9742

NPI assigned

May 16, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 6

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

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.

• Senior Life Management, P.L.L.C.

  • Clinical Psychologist
  • Carle Place, NY
  • NPI 1396799557
  NPD (past)

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

{
    "created_epoch": "1147737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1442793600000",
    "number": "1811948441",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "34 SLEEPY HOLLOW DR",
            "city": "DANBURY",
            "state": "CT",
            "postal_code": "068105361",
            "telephone_number": "203-448-9742"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "523 E PUTNAM AVE",
            "address_2": "SUITE 24",
            "city": "GREENWICH",
            "state": "CT",
            "postal_code": "068304877",
            "telephone_number": "203-448-9742"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHORK",
        "first_name": "EDWARD",
        "middle_name": "JOSEPH",
        "name_suffix": "Jr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-16",
        "last_updated": "2015-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "008855",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CT",
            "license": "001636",
            "primary": true
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "CT",
            "license": "001636",
            "primary": false
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "NY",
            "license": "08855",
            "primary": false
        },
        {
            "code": "103TB0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Cognitive & Behavioral",
            "state": "CT",
            "license": "001636",
            "primary": false
        },
        {
            "code": "103TB0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Cognitive & Behavioral",
            "state": "NY",
            "license": "008855",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01802088",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Linda Schlapfer, LMFT
• Marcia Jo Schlechter
• Megan Magnusson Schmeiler, LCSW
• Marcie Beth Schneider, M.D.
• Rachel Schneider
• Suzanne Schuster, MSW
• Ilanna Sue Schwalbe, MA, OTR, CHT
• Matthew Michael Scott, DO
• See Inc
• Shiva E Seejore, PA-C

• Clinical Psychologist in Greenwich, CT
• Providers in Greenwich, CT by specialty
• Clinical Psychologist in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2015; 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.