Jacquelyn O'Connor, PSYD

Primary specialty

PsychologistTaxonomy code 103T00000X

License

023691 Issued in NY

Practice address

20 Century Hill Dr Ste 202
Latham, NY 12110-2198

Phone

(518) 785-7283

NPI assigned

Aug 18, 2025

Sex

Female

Sole proprietor

Yes

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

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Capital District Behavioral Health Psychologists, PLLC

  • Clinical Psychologist
  • Latham, NY
  • NPI 1215152962
  NPD

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

{
    "created_epoch": "1755475200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755475200000",
    "number": "1891672226",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 CENTURY HILL DR STE 202",
            "city": "LATHAM",
            "state": "NY",
            "postal_code": "121102198"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 CENTURY HILL DR STE 202",
            "city": "LATHAM",
            "state": "NY",
            "postal_code": "121102198",
            "telephone_number": "518-785-7283"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'CONNOR",
        "first_name": "JACQUELYN",
        "credential": "PSYD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-08-18",
        "last_updated": "2025-08-18",
        "certification_date": "2025-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NY",
            "license": "023691",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Northeast Eye Billing
• Northeast Infusion Therapy Inc
• Northeast Ophthalmology PLLC
• Nutrisma LLC
• Amy Andrukonis Nylund
• Katherine Anna O'Connor, PHD
• Zyra Cortez O'Connor, M.D.
• Colleen O'Donnell-Nichols, RPH
• Emily Rose O'Donnell, FNP-BC
• Aimee O'Keefe, LCSW

• Psychologist in Latham, NY
• Providers in Latham, NY by specialty
• Psychologist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2025; 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.