Sera Lavelle, PH.D

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

021126 Issued in NY

Practice address

177 Prince St Apt 501
New York, NY 10012-2935

Phone

(646) 537-1713

NPI assigned

Jun 21, 2011

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

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective May 1, 2017 through May 1, 2027

Medicare enrollment (NPD)

Not 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.

• Soho Integrative Psychological Services PLLC

  • Clinical Psychologist
  • New York, NY
  • NPI 1215621545
  NPD Authorized official
• Ny Health Hypnosis Inc

  • Clinical Psychologist
  • New York, NY
  • NPI 1326572991
  NPD (past) Authorized official

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

{
    "created_epoch": "1308614400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1430265600000",
    "number": "1891081527",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "177 PRINCE ST APT 501",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100122935",
            "telephone_number": "646-537-1713"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "177 PRINCE ST APT 501",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100122935",
            "telephone_number": "646-537-1713"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAVELLE",
        "first_name": "SERA",
        "name_prefix": "Dr.",
        "credential": "PH.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-06-21",
        "last_updated": "2015-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "021126",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kayla Lavelle
• Lisa Lavelle, L.C.S.W.
• Lisa P Lavelle
• Michael Paul Lavelle Jr., M.D.
• Rebecca Dzenis Lavelle
• Elana Pearl Lavenda, OTR/L
• Lavender California Psychiatric Nursing PC
• Lavender Health NP in Family Health PLLC
• Lavender Kansas Psychiatric Nurse Practitioner PA
• Lavender New Jersey Psychiatric Nurse Practitioner PC

• Clinical Psychologist in New York, NY
• Providers in New York, 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 Apr 29, 2015; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.