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: July 19, 2026.

  • Organization
  • Psychologist
  • Clinical

About BOOMER PSYCHOLOGICAL SERVICES PC

This page provides the complete NPI Profile along with additional information for Boomer Psychological Services Pc, a provider established in New York, New York operating as a Psychologist, focusing in clinical . The healthcare provider is registered in the NPI registry with number 1992132963 assigned on October 2013. The practitioner's primary taxonomy code is 103TC0700X with license number 011975 (NY). The provider is registered as an organization and their NPI record was last updated 13 years ago. The organization operates as a Single Specialty Group with one or more individual practitioners, all of who practice with the same area of specialization. The authorized official of this NPI record is Bonnie Kellen Phd (President)

NPI
1992132963 Verify this NPI
Provider Name
BOOMER PSYCHOLOGICAL SERVICES PC
Entity Type
Organization
Location Address
201 E 77TH ST APT 16E NEW YORK, NY 10075
Location Phone
(212) 861-0740
Mailing Address
201 E 77TH ST APT 16E NEW YORK, NY 10075
Mailing Phone
(212) 861-0740
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
10-04-2013
Last Update Date
10-04-2013
Code Navigator

A clinical psychologist like Boomer Psychological Services Pc assesses, diagnoses, and treats mental, emotional, and behavioral disorders. Clinical psychologists help people deal with problems ranging from short-term personal issues to severe, chronic conditions. Clinical psychologists interview patients, give diagnostic tests, provide psychotherapy and design behavior modification programs to help patients.

Location Map

Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Psychologist Clinical

Taxonomy Code
103TC0700X
Type
Behavioral Health & Social Service Providers
License No.
011975
License State
NY
Taxonomy Description
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.

Group Taxonomy 193400000X SINGLE SPECIALTY GROUP

This provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

BONNIE KELLEN PHD

Authorized Official Title
PRESIDENT
Authorized Official Phone
(212) 861-0740

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Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1992132963, enumerated as an "organization" on October 04, 2013.

The provider is located at 201 E 77TH ST APT 16E NEW YORK, NY 10075 and the phone number is (212) 861-0740.

Psychologist with taxonomy code 103TC0700X and a focus in Clinical.