Active NPI
Alyne De Souza Stedman, PH.D.
- Clinical Psychologist
- Chittenango, NY
National Provider Identifier
1841911690
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 026241
- Practice address
- 602 Button Rd
Chittenango, NY 13037-1211 - Phone
- (860) 389-6617
- NPI assigned
- Sep 9, 2022
- Last updated
- Jan 22, 2024
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 026241 | NY | Primary |
Addresses
Primary practice location
602 Button Rd
Chittenango, NY 13037-1211
Mailing address
602 Button Rd
Chittenango, NY 13037-1211
Phone (860) 389-6617
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)
- Not enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 026241 | NY | MD | Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Psychiatry Faculty Practice, Inc. | Clinical | Past | Accepting new patients |
Organizations & group practices 1
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1662681600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1705881600000",
"number": "1841911690",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "602 BUTTON RD",
"city": "CHITTENANGO",
"state": "NY",
"postal_code": "130371211",
"telephone_number": "860-389-6617"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "602 BUTTON RD",
"city": "CHITTENANGO",
"state": "NY",
"postal_code": "130371211",
"telephone_number": "860-389-6617"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DE SOUZA STEDMAN",
"first_name": "ALYNE",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-09-09",
"last_updated": "2024-01-22",
"certification_date": "2024-01-22",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "NY",
"license": "026241",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Chittenango, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.