NPIMap

Organization Active NPI

Psychological Health Care of Ny

  • Psychologist
  • Brooklyn, NY
National Provider Identifier
1952464059
Registry record updated May 10, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
009369 Issued in NY
Legal business name
PSYCHOLOGICAL HEALTH CARE OF NY
Practice address
2797 Ocean Pkwy
Brooklyn, NY 11235-7861
Phone
(718) 743-7700
NPI assigned
Dec 19, 2006
Last updated
May 10, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 10, 2008

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

Authorized official

Name
Dr. Michael E Kissin, PH.D.NPI 1053488361
Title
Owner
Phone
(718) 332-6025

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 009369 NY Primary

Addresses

Primary practice location

2797 Ocean Pkwy
Brooklyn, NY 11235-7861

Mailing address

65 Oriental Blvd Apt 12C
Brooklyn, NY 11235-4913
Phone (718) 332-6025

Other identifiers 5

IdentifierTypeStateIssuer
009369OtherNYLICENCE#
VWW351OtherNYBCBS
01499105MedicaidNY
P2786335OtherNYOXFORD
2319570OtherNYUHC

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1166486400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1210377600000",
    "number": "1952464059",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "65 ORIENTAL BLVD APT 12C",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112354913",
            "telephone_number": "718-332-6025"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2797 OCEAN PKWY",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112357861",
            "telephone_number": "718-743-7700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PSYCHOLOGICAL HEALTH CARE OF NY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-19",
        "last_updated": "2008-05-10",
        "status": "A",
        "authorized_official_last_name": "KISSIN",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "718-332-6025",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NY",
            "license": "009369",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENCE#",
            "identifier": "009369",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "VWW351",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01499105",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD",
            "identifier": "P2786335",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UHC",
            "identifier": "2319570",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2008; 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.