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BOOMER PSYCHOLOGICAL SERVICES PC
NPI 1992132963
Psychologist - Clinical in New York, NY

Active since October 04, 2013
201 E 77TH ST APT 16E, NEW YORK, NY 10075(212) 861-0740 Get Directions Write a Review

NPPES record last updated: October 4, 2013. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Boomer Psychological Services Pc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

BOOMER PSYCHOLOGICAL SERVICES PC (NPI 1992132963) is a healthcare organization registered as a clinical in New York, New York and active in the NPI registry since October 2013. The organization lists Bonnie Kellen, President, as its authorized official.

NPPES Registry Identity

NPI1992132963
Entity TypeOrganization
Primary Taxonomy103TC0700X
Legal Business NameBOOMER PSYCHOLOGICAL SERVICES PC
Location Address201 E 77TH ST APT 16ENew York, NY 10075-2085
Mailing Address201 E 77th St Apt 16eNew York, NY 10075-2085 · (212) 861-0740
Phone(212) 861-0740
Organization SubpartNo
Authorized OfficialBonnie KellenPresident · (212) 861-0740
Enumeration DateOctober 4, 2013
✔ NPI 1992132963 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychologist · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code103TC0700X
License✔ Licensed in NY · 011975
Definition
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.
201 E 77TH ST APT 16E, New York, NY 10075
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Boomer Psychological Services PC's NPI number?

The NPI number for Boomer Psychological Services PC is 1992132963. It was assigned to this organization in the NPPES registry on October 4, 2013.

Where is Boomer Psychological Services PC located?

Boomer Psychological Services PC is located at 201 E 77th St Apt 16E, New York, NY 10075. The listed phone number is (212) 861-0740.

What is Boomer Psychological Services PC's specialty?

The primary specialty registered for this NPI is Psychologist, specializing in Clinical, with taxonomy code 103TC0700X.

When was this NPI record last updated?

The NPPES record for Boomer Psychological Services PC was last updated on October 4, 2013. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.