Individual provider Active NPI

Alice R. Shepard, PHD

  • Clinical Psychologist
  • New York, NY
National Provider Identifier
1851600258
Registry record updated Oct 2, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
018801-1 Issued in NY
Practice address
31 W 9TH St
Suite 1
New York, NY 10011-9206
Phone
(347) 330-9901
NPI assigned
Oct 2, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 2, 2010

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 018801-1 NY Primary

Addresses

Primary practice location

31 W 9TH St
Suite 1
New York, NY 10011-9206

Mailing address

31 W 9TH St
Suite 1
New York, NY 10011-9206
Phone (347) 330-9901

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

LicenseStateTypeSpecialty
018801-1NYMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1285977600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1285977600000",
    "number": "1851600258",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31 W 9TH ST",
            "address_2": "SUITE 1",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100119206",
            "telephone_number": "347-330-9901"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31 W 9TH ST",
            "address_2": "SUITE 1",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100119206",
            "telephone_number": "347-330-9901"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHEPARD",
        "first_name": "ALICE",
        "middle_name": "R.",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-10-02",
        "last_updated": "2010-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "018801-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2010; 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.