Individual provider Active NPI

Maryellen Hurwitz, PHD

  • Clinical Psychologist
  • Flushing, NY
National Provider Identifier
1972306280
Registry record updated Mar 31, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
014226 Issued in NY
Practice address
14415 68TH Rd
Flushing, NY 11367-1330
Phone
(973) 264-0023
Fax
(973) 264-0022
NPI assigned
Mar 31, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 31, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 014226 NY Primary

Addresses

Primary practice location

14415 68TH Rd
Flushing, NY 11367-1330

Mailing address

2719 Hollywood Blvd Ste 5469
Hollywood, FL 33020-4821
Phone (973) 264-0023

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250506000173 NY Practitioner - Clinical Psychologist 4789101551 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Senior Care Therapy Psychology of New York PLLCGroup PAC ID 2264774793, 10 clinicians

Practice addresses (Care Compare)

14415 68TH Rd
Flushing, NY 11367-1330
Phone (973) 264-0023

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
014226NYMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Senior Care Therapy LCSW of New York PLLC CurrentSince Mar 1, 2025 Accepting new patients
Senior Care Therapy Psychology of New York PLLC Clinical CurrentSince Mar 1, 2025 Accepting new patients

Locations

2719 Hollywood Blvd
Hollywood, FL 33020
Phone (954) 354-2555

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1743379200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743379200000",
    "number": "1972306280",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2719 HOLLYWOOD BLVD STE 5469",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330204821",
            "telephone_number": "973-264-0023",
            "fax_number": "973-264-0022"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14415 68TH RD",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113671330",
            "telephone_number": "973-264-0023",
            "fax_number": "973-264-0022"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HURWITZ",
        "first_name": "MARYELLEN",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-03-31",
        "last_updated": "2025-03-31",
        "certification_date": "2025-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "014226",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Flushing, NY

Sources for this page

Verify at the official NPI Registry.