Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Boomer Psychological Services PC

Organization Clinical Psychologist · NPI 1992132963

Boomer Psychological Services PC is a Clinical Psychologist in New York, New York. Licensed in New York. Registered with an NPI since 2013.

Licensed in
NY
In the registry since
2013
What do these letters mean?
PC — Professional corporation
A form of business registration, not a clinical qualification.

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Practice location Address checks out

201 E 77th St Apt 16E
New York, NY 10075-2085
Phone: (212) 861-0740
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Psychologist (primary) Taxonomy 103TC0700X · Licence 011975 (NY)

Record details

NPI number1992132963
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Bonnie Kellen — President · (212) 861-0740
NPI enumeratedOctober 4, 2013
Last updated in NPPESOctober 4, 2013
Mailing address201 E 77th St Apt 16e, New York, NY 10075-2085

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