National Provider Identifier Database

JASON M RUDOLPH, PSY.D. – NPI #1174404016
Clinical

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.


Contact Information

JASON M RUDOLPH, PSY.D.
48 SOUTH BREEZE DRIVE
WAINSCOTT, NY11975
Phone: 917-750-8400
Fax:
Website:
Specialty Taxonomy Code
* Clinical 103TC0700X

* Indicates primary specialty

NPI Profile & details for JASON M RUDOLPH

NPI Number 1174404016
Credentials PSY.D. (Doctor of Psychology)
Entity Individual
Enumeration date 09/09/2025
Last updated 09/09/2025 - About 9 months ago
Sole proprietor1 No
Identifiers
  • CA License #: 35868
  • NY License #: 017306
Hospital affiliation n/a

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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