NPIMap

Organization Active NPI

Dr. Katherine Bothos, LLC

  • Clinical Psychologist
  • Fairfield, CT
National Provider Identifier
1033438015
Registry record updated Jul 8, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
002950 Issued in CT
Legal business name
DR. KATHERINE BOTHOS, LLC
Practice address
170 Post Rd Ste 208
Fairfield, CT 06824-6242
Phone
(203) 455-3736
NPI assigned
May 29, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2019

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

Authorized official

Name
Dr. Katherine BothosNPI 1114254836
Title
Clinical Psychologist
Phone
(203) 838-8344

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103TC0700X 002950 CT Primary

Addresses

Primary practice location

170 Post Rd Ste 208
Fairfield, CT 06824-6242

Mailing address

704 Thorme St
Bridgeport, CT 06606-4022
Phone (203) 838-8344

Other practice location 1

161 East Ave Ste 204
Norwalk, CT 06851-5710
Phone (203) 838-8344

National Provider Directory

National Provider Directory
Tax ID family
Dr Katherine Bothos LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1275091200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1562544000000",
    "number": "1033438015",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "704 THORME ST",
            "city": "BRIDGEPORT",
            "state": "CT",
            "postal_code": "066064022",
            "telephone_number": "203-838-8344"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "170 POST RD STE 208",
            "city": "FAIRFIELD",
            "state": "CT",
            "postal_code": "068246242",
            "telephone_number": "203-455-3736"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "161 East Ave Ste 204",
            "address_purpose": "LOCATION",
            "city": "Norwalk",
            "state": "CT",
            "postal_code": "068515710",
            "country_code": "US",
            "telephone_number": "203-838-8344",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "DR. KATHERINE BOTHOS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-05-29",
        "last_updated": "2019-07-08",
        "status": "A",
        "authorized_official_last_name": "BOTHOS",
        "authorized_official_first_name": "KATHERINE",
        "authorized_official_title_or_position": "CLINICAL PSYCHOLOGIST",
        "authorized_official_telephone_number": "203-838-8344",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "CT",
            "license": "002950",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairfield, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.