Active NPI
Amanda Pearlberg, PSY.D.
- Clinical Psychologist
- Massapequa Park, NY
National Provider Identifier
1992443634
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 024236
- Practice address
- 132 Harbor LN
Massapequa Park, NY 11762-4003 - Phone
- (516) 331-4331
- NPI assigned
- May 23, 2022
- Sex
- Female
- Sole proprietor
- No
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 | 024236 | NY | Primary |
Addresses
Primary practice location
132 Harbor LN
Massapequa Park, NY 11762-4003
Mailing address
132 Harbor LN
Massapequa Park, NY 11762-4003
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 024236 | NY | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1653264000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1653264000000",
"number": "1992443634",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "132 HARBOR LN",
"city": "MASSAPEQUA PARK",
"state": "NY",
"postal_code": "117624003"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "132 HARBOR LN",
"city": "MASSAPEQUA PARK",
"state": "NY",
"postal_code": "117624003",
"telephone_number": "516-331-4331"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PEARLBERG",
"first_name": "AMANDA",
"name_prefix": "Dr.",
"credential": "PSY.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-05-23",
"last_updated": "2022-05-23",
"certification_date": "2022-05-23",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "NY",
"license": "024236",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Massapequa Park, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.