Audrey Hope Van Voolen, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

015308 Issued in NY

Practice address

3460 Country Line Road
Skaneateles, NY 13152

Phone

(315) 415-0157

NPI assigned

Dec 9, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• Audrey Van Voolen Kissel Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Jun 14, 2023 through Jun 14, 2027

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1165622400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1557792000000",
    "number": "1841350113",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3460 COUNTRY LINE ROAD",
            "city": "SKANEATELES",
            "state": "NY",
            "postal_code": "13152",
            "telephone_number": "315-415-0157"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3460 COUNTRY LINE ROAD",
            "city": "SKANEATELES",
            "state": "NY",
            "postal_code": "13152",
            "telephone_number": "315-415-0157"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAN VOOLEN",
        "first_name": "AUDREY",
        "middle_name": "HOPE",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-09",
        "last_updated": "2019-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "015308-1",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "015308",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AUDREY",
            "last_name": "KISSEL",
            "middle_name": "VAN VOOLEN",
            "credential": "PH.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Cheryl Allen Tompkins, M.S., CCC/SLP
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• John Joseph Turner, D.D.S.
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• Neil Vance, D.C.
• Amy Lynn Vanholtz, LPN
• Vernak Farms Country Store
• Charlene Mary Vernak, RPH

• Clinical Psychologist in Skaneateles, NY
• Providers in Skaneateles, NY by specialty
• Clinical Psychologist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.