Lydia Peretz, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

013038 Issued in NY

Practice address

8522 125TH St
Kew Gardens, NY 11415-3311

Phone

(718) 441-6432

NPI assigned

Jun 6, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

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": "1149552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1871532853",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 OLD COUNTRY RD",
            "address_2": "SUITE 271",
            "city": "CARLE PLACE",
            "state": "NY",
            "postal_code": "115141801",
            "telephone_number": "800-725-6280",
            "fax_number": "800-725-6380"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8522 125TH ST",
            "city": "KEW GARDENS",
            "state": "NY",
            "postal_code": "114153311",
            "telephone_number": "718-441-6432"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERETZ",
        "first_name": "LYDIA",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-06",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "013038",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Passion for Seniors of Ny Inc
• Hiral Patel, PA-C
• Marie A Patterson, OT
• Gerald Pekler, M.D.
• Alina Pena Adames
• Julia M Perez-Holguin
• Monica Perry, CASAC 2
• Andrew Peters, LCSW-R
• Christina Rose Petkanas
• Laura Ann Pfister

• Clinical Psychologist in Kew Gardens, NY
• Providers in Kew Gardens, 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 Jul 13, 2026; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.