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BOOMER PSYCHOLOGICAL SERVICES PC NPI 1992132963


NPI Information

NPI: 1992132963
Provider Name: BOOMER PSYCHOLOGICAL SERVICES PC
Classification: Psychologist - 103TC0700X
Entity Type: Organization

Specialization: Clinical

Address:
201 E 77TH ST APT 16E
NEW YORK, NY
ZIP 10075
Phone: (212) 861-0740
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BOOMER PSYCHOLOGICAL SERVICES PC is a clinical psychologist in New York, NY. The provider is a psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in breadth -- one that is broadly inclusive of severe psychopathology -- and marked by comprehensiveness and integration of knowledge and skill from a broad array of disciplines within and outside of psychology proper. The scope of clinical psychology encompasses all ages, multiple diversities and varied systems. BOOMER PSYCHOLOGICAL SERVICES PC NPI is 1992132963. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

201 E 77TH ST APT 16E
NEW YORK, NY
ZIP 10075-085
Phone: (212) 861-0740

The provider's authorized official is Bonnie Kellen .
The authorized official title is President and has the following contact phone number (212) 861-0740.

The enumeration date for this NPI number is 10/4/2013 and was last updated on 10/4/2013.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1103TC0700XPsychologistClinical011975NEW YORKYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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