Nina Obolensky Prudden, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

200571 Issued in NY

Practice address

109 Grand St
Croton on Hudson, NY 10520-2304

Phone

(914) 862-4127

NPI assigned

Jun 24, 2013

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 7

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1372032000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1423699200000",
    "number": "1912346925",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "62 FARRINGTON RD",
            "city": "CROTON ON HUDSON",
            "state": "NY",
            "postal_code": "105201903",
            "telephone_number": "914-862-4127"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "109 GRAND ST",
            "city": "CROTON ON HUDSON",
            "state": "NY",
            "postal_code": "105202304",
            "telephone_number": "914-862-4127"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRUDDEN",
        "first_name": "NINA",
        "middle_name": "OBOLENSKY",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-06-24",
        "last_updated": "2015-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NY",
            "license": "200571",
            "primary": false
        },
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "NY",
            "license": "200571",
            "primary": false
        },
        {
            "code": "103TA0400X",
            "taxonomy_group": "",
            "desc": "Psychologist, Addiction (Substance Use Disorder)",
            "state": "NY",
            "license": "200571",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "200571",
            "primary": true
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "NY",
            "license": "200571",
            "primary": false
        },
        {
            "code": "103TM1800X",
            "taxonomy_group": "",
            "desc": "Psychologist, Intellectual & Developmental Disabilities",
            "state": "NY",
            "license": "200571",
            "primary": false
        },
        {
            "code": "103TS0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, School",
            "state": "NY",
            "license": "200571",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alissa Peters
• Javier Emilio Picayo, MS, LAC
• Linda Plastrik, LCSW
• Scott Lee Poritzky, DC
• Barbara Powers, SLP
• Anna Pucelak-Drabek
• Samantha Puff, LMSW
• Anthony Quijano, OTR/L
• Marilyn G Quinones, P.T.A.
• Eugene Rajaratnam, MD

• Clinical Psychologist in Croton on Hudson, NY
• Providers in Croton on Hudson, 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 Feb 12, 2015; 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.