Active NPI
Michelle Jaffe
- Clinical Psychologist
- New York, NY
National Provider Identifier
1992316863
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 023748
- Practice address
- 156 W 56TH St Ste 1804
New York, NY 10019-3878 - Phone
- (212) 851-8100
- Fax
- (212) 537-0102
- NPI assigned
- Aug 13, 2020
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 023748 | NY | Primary |
Addresses
Primary practice location
156 W 56TH St Ste 1804
New York, NY 10019-3878
Mailing address
17 Canterbury Dr
Greenwich, CT 06831-4901
Phone (917) 846-1596
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 023748 | Other | NY | LICENSE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1597276800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1597276800000",
"number": "1992316863",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "17 CANTERBURY DR",
"city": "GREENWICH",
"state": "CT",
"postal_code": "068314901",
"telephone_number": "917-846-1596",
"fax_number": "212-537-0102"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "156 W 56TH ST STE 1804",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100193878",
"telephone_number": "212-851-8100",
"fax_number": "212-537-0102"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JAFFE",
"first_name": "MICHELLE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-08-13",
"last_updated": "2020-08-13",
"certification_date": "2020-08-13",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "NY",
"license": "023748",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSE",
"identifier": "023748",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in New York, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.