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Deactivated NPI 1225027964 Deactivated / Inactive NPI Male Practitioner

Dr. Charles Keith , PsyD

Psychologist • Bayside, NY

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Dr. Charles Keith has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date October 15, 2005
NPI Deactivation Date August 24, 2022
Total Practice Duration ~17 Years of Practice (2005 – 2022)

Professional Overview & Biography Verified Profile Summary

Dr. Charles Keith, PsyD was a registered Psychologist practicing in Bayside, NY. Throughout an active medical career spanning 17 years, Dr. Keith provided care at the practice location at 21426 41ST AVE until profile deactivation on 2022-08-24.

Practice Location & Contact Primary Location

Practice Address

21426 41st Ave
Siute 204

Bayside, NY 113612107

Telephone 7184687510

Specialty Benchmarks & Practice Insights

Comparative analytics for Psychologist in Bayside, NY

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 19.0 Yrs
State Avg: 30.1 Yrs
Regional Practice Density
13 Specialists

Practicing in Bayside, NY (5379 Statewide)

Telehealth Adoption Rate
15.4% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Psychologist Primary Specialty

NUCC Taxonomy Code: 103T00000X

State License NY 010610

A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

13 Associated Practitioners
Jessica Gershen

Case Manager/Care Coordinator

NPI 1013309004
Johanna Arteaga

Case Manager/Care Coordinator

NPI 1124374285
Desiree Estevez

Case Manager/Care Coordinator

NPI 1235485392
Deirdre Eng , TEACHER

Behavior Analyst

NPI 1285984336
Narmeen Husssain , CRC

Case Manager/Care Coordinator

NPI 1386046126

Certified Rehabilitation Counselor

NPI 1386991776

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

7 Historical Events
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NPI Profile Deactivated August 24, 2022

Record deactivated on August 24, 2022

NPI Profile Active July 08, 2007

NPI status registered as active in NPPES database

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Updated Practice Location July 08, 2007

Registered at 21426 41ST AVE, SIUTE 204, BAYSIDE, NY 113612107 (Tel: 7184687510)

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Updated Business Mailing Address July 08, 2007

Registered at 7350 BELL BLVD, 6E, OAKLAND GARDENS, NY 113642938 (Tel: 7184687510)

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Provider Name / Credentials Updated July 08, 2007

Recorded as CHARLES KEITH, PSY.D.

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Medical Taxonomy / Specialty Registered (Primary Specialty) July 08, 2007

Psychologist (License #010610 in NY)

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Initial NPI Registration & Enumeration October 15, 2005

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1225027964
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: October 15, 2005
Last Update: July 08, 2007
Deactivation Date: August 24, 2022

Mailing Address

7350 Bell Blvd, 6e

Oakland Gardens, NY 113642938

Phone: 7184687510

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.