Tracey A. Botham, LCSW-R

Primary specialty

Social WorkerTaxonomy code 104100000X

License

079070-1 Issued in NY

Practice address

425 Main St.
Dunkirk, NY 14048

Phone

(716) 366-3533

Fax

(716) 363-1184

NPI assigned

Sep 16, 2006

Last updated

Oct 20, 2020By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Tat Sum Lee, M.D.

  • Internal Medicine Physician
  • Dunkirk, NY
  • NPI 1306947072
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1158364800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603152000000",
    "number": "1003912700",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "741 DELAWARE AVE",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142092201",
            "telephone_number": "716-218-1400",
            "fax_number": "716-332-2820"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "425 MAIN ST.",
            "city": "DUNKIRK",
            "state": "NY",
            "postal_code": "14048",
            "telephone_number": "716-366-3533",
            "fax_number": "716-363-1184"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOTHAM",
        "first_name": "TRACEY",
        "middle_name": "A.",
        "credential": "LCSW-R",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-16",
        "last_updated": "2020-10-20",
        "certification_date": "2020-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "079070-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cathleen Berner
• John D. Berner, D.D.S.
• Anneliese Bienko, LMSW
• Jordan Blair
• Ravinder Singh Boparai, DDS
• Bridging the Gap OT, LLC
• Kia Lyn Briggs
• Brooks Memorial Hospital
• Brooks-TLC Hospital System, Inc.
• Brooks-TLC Hospital System, Inc.

• Social Worker in Dunkirk, NY
• Providers in Dunkirk, NY by specialty
• Social Worker in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.