Christine Coolidge RN CS PHD PC

Primary specialty

PsychologistTaxonomy code 103T00000X

License

0148401 Issued in NY

Legal business name

CHRISTINE COOLIDGE RN CS PHD PC

Practice address

186 W Montauk Hwy D 1
Hampton Bays, NY 11946

Phone

(631) 728-2000

NPI assigned

Nov 15, 2006

Last updated

Jul 20, 2007By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Christine Coolidge, RN CS PHDNPI 1255525549

Title

President

Phone

(631) 728-2000

Specialties & licenses 2

Addresses

Other names 1

• Long Island Pain & Stress Hampton Pain & Stress Other name

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Christine Coolidge, PHD

  • Psychologist
  • Hampton Bays, NY
  • NPI 1255525549
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1163548800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1184889600000",
    "number": "1932272309",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18 DUCKWOOD LA",
            "city": "HAMPTON BAYS",
            "state": "NY",
            "postal_code": "11946",
            "telephone_number": "631-728-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "186 W MONTAUK HWY D 1",
            "city": "HAMPTON BAYS",
            "state": "NY",
            "postal_code": "11946",
            "telephone_number": "631-728-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHRISTINE COOLIDGE RN CS PHD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-15",
        "last_updated": "2007-07-20",
        "status": "A",
        "authorized_official_last_name": "COOLIDGE",
        "authorized_official_first_name": "CHRISTINE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "631-728-2000",
        "authorized_official_credential": "RN CS PHD"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NY",
            "license": "0148401",
            "primary": true
        },
        {
            "code": "364S00000X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist",
            "state": "NY",
            "license": "2428621",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Long Island Pain & Stress Hampton Pain & Stress",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Catholic Charities of the Diocese of Rockville Centre
• Catholic Guardian Society & Home Bureau
• Deborah Cavaliere, LCSW
• Wayne J Cavaliere
• Michelle Lee Cettina, MSW
• April Marie Cintron, LPN
• Jennifer Ann Clemente, MS, CNS, CDN
• Marlene S Clifford
• Briana Nicole Cohen, MD
• James Constantine

• Psychologist in Hampton Bays, NY
• Providers in Hampton Bays, NY by specialty
• Psychologist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.