Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Dr. Theodora Stolz, PHDPSYCHOLOGIST

Individual provider Clinical Psychologist · NPI 1558446245

Dr. Theodora Stolz, PHDPSYCHOLOGIST is a Clinical Psychologist in Staten Island, New York. Qualified in 1989, 37 years ago. Accepts Medicare assignment. Licensed in New Jersey and New York.

Years since qualifying
37
Licensed in
NJ, NY
In the registry since
2006
Specialties on file
2
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Practice location Address checks out

68 Guyon Ave
Staten Island, NY 10306
Phone: (718) 980-3780
Fax: (718) 987-6113
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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 010825 (NY)
Clinical Psychologist Taxonomy 103TC0700X · Licence 3222 (NJ)

Record details

NPI number1558446245
Entity typeIndividual (Type 1)
GenderFemale
Credentials PHDPSYCHOLOGIST
Sole proprietorNo
NPI enumeratedOctober 25, 2006
Last updated in NPPESJune 20, 2013

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCLINICAL PSYCHOLOGIST
Medical schoolOTHER
Graduated 1989 (37 years in practice)
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

Other providers in Staten Island