Brent Ivan Bounds, PHD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

019071 Issued in NY

Practice address

276 5TH Ave Ste 507B.6
New York, NY 10001-4509

Phone

(646) 455-3539

NPI assigned

May 4, 2011

Sex

Male

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

Credentials

Doctor of Philosophy

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

{
    "created_epoch": "1304467200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1304467200000",
    "number": "1902198302",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "149 W 95TH ST APT A",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100256650",
            "telephone_number": "917-833-7935"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "276 5TH AVE STE 507B.6",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100014509",
            "telephone_number": "646-455-3539"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOUNDS",
        "first_name": "BRENT",
        "middle_name": "IVAN",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-05-04",
        "last_updated": "2011-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "019071",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Monica Gamal Boulos, MD
• Melissa Boulter
• Emily Boulukos, CCC-SLP
• Bounce Back Physical Therapy, PC
• Boundless LCSW PLLC
• Isabelle Quinn Boundy
• Caroline Samantha Bourassa, CPNP
• Stephanie Paige Bourassa, MSTOM, LAC
• Rina Bourbia
• Gabrielle Lucia Bourdeau

• 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 May 4, 2011; 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.