Healthcare Provider Details

I. General information

NPI: 1346454279
Provider Name (Legal Business Name): KAREN MARISAK PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/09/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20 W 86TH ST SUITE 1AA
NEW YORK NY
10024-3604
US

IV. Provider business mailing address

20 W 86TH ST SUITE 1AA
NEW YORK NY
10024-3604
US

V. Phone/Fax

Practice location:
  • Phone: 212-874-6487
  • Fax: 212-866-7737
Mailing address:
  • Phone: 212-874-6487
  • Fax: 212-866-7737

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number006694
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code103TA0400X
TaxonomyAddiction (Substance Use Disorder) Psychologist
License Number006694
License Number StateNY
# 3
Primary TaxonomyN
Taxonomy Code103TA0700X
TaxonomyAdult Development & Aging Psychologist
License Number006694
License Number StateNY
# 4
Primary TaxonomyY
Taxonomy Code103TB0200X
TaxonomyCognitive & Behavioral Psychologist
License Number006694
License Number StateNY
# 5
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number006694
License Number StateNY
# 6
Primary TaxonomyN
Taxonomy Code103TC2200X
TaxonomyClinical Child & Adolescent Psychologist
License Number006694
License Number StateNY
# 7
Primary TaxonomyN
Taxonomy Code103TF0000X
TaxonomyFamily Psychologist
License Number006694
License Number StateNY
# 8
Primary TaxonomyN
Taxonomy Code103TP0814X
TaxonomyPsychoanalysis Psychologist
License Number006694
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: