Stephanie Helena Poplock, PHD, LCSW

Primary specialty

PsychologistTaxonomy code 103T00000X

License

018721 Issued in NY

Practice address

242 Main Street
Oneonta, NY 13820

Phone

(607) 433-2343

Fax

(607) 433-6229

NPI assigned

Jun 13, 2006

Last updated

Jul 1, 2020By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 4

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

Specialty

Clinical Psychologist

Education

Other, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

County of OtsegoGroup PAC ID 9032195573, 9 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Locations

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

• County of Otsego

  dba Otsego County Mental Health Clinic

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Oneonta, NY
  • NPI 1831145101
  Medicare reassignment Care Compare group NPD
• County of Otsego

  • Land Ambulance
  • Cooperstown, NY
  • NPI 1801555214
  NPD
• Northeast Occupational Exchange, Inc

  • Psychologist
  • Bangor, ME
  • NPI 1427002138
  NPD (past)

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

{
    "created_epoch": "1150156800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1593561600000",
    "number": "1841233459",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "242 MAIN STREET",
            "city": "ONEONTA",
            "state": "NY",
            "postal_code": "13820",
            "telephone_number": "607-433-2343",
            "fax_number": "607-433-6229"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "242 MAIN STREET",
            "city": "ONEONTA",
            "state": "NY",
            "postal_code": "13820",
            "telephone_number": "607-433-2343",
            "fax_number": "607-433-6229"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POPLOCK",
        "first_name": "STEPHANIE",
        "middle_name": "HELENA",
        "name_prefix": "Dr.",
        "credential": "PHD, LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-13",
        "last_updated": "2020-07-01",
        "certification_date": "2020-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NY",
            "license": "018721",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "077995",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03641807",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "421230099",
            "state": "ME"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "J400040149",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM LEGACY NUMBER",
            "identifier": "098304",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Marissa Anne Pomarico-Maxson
• Gerald Daniel Pondolfino, D.D.S.
• Robert Bruce Pondolfino Jr., D.D.S.
• Annemarie Gilsenan Poole, NP
• Hilary Frances Pope, LCSW
• Nicole R Posey
• Samuel Eanet Press, M.D.
• Christopher Ryan Pula
• Quality Hearing Instruments LLC (Miracle Ear)
• Maureen Quinn, PT, DPT

• Psychologist in Oneonta, NY
• Providers in Oneonta, NY by specialty
• Psychologist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.