Camille Myoko Botticelli-Pohl

Primary specialty

PsychologistTaxonomy code 103T00000X

License

0810009200 Issued in VA

Practice address

163 Veterans Dr
White River Junction, VT 05001-7005

Phone

(802) 295-9363

NPI assigned

Mar 16, 2023

Sex

Female

Sole proprietor

Yes

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

Medicare enrollment (NPD)

Not 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 and National Provider Directory roles.

• Windsor Hospital Corporation

  • Internal Medicine Physician
  • Windsor, VT
  • NPI 1841287984

  Single Specialty

  NPD (past)

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

{
    "created_epoch": "1678924800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1771891200000",
    "number": "1043911902",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "163 VETERANS DR",
            "city": "WHITE RIVER JUNCTION",
            "state": "VT",
            "postal_code": "050017005",
            "telephone_number": "802-295-9363"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "163 VETERANS DR",
            "city": "WHITE RIVER JUNCTION",
            "state": "VT",
            "postal_code": "050017005",
            "telephone_number": "802-295-9363"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOTTICELLI-POHL",
        "first_name": "CAMILLE",
        "middle_name": "MYOKO",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-03-16",
        "last_updated": "2026-02-24",
        "certification_date": "2026-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist",
            "state": "VA",
            "license": "0810009200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nori H Bokum, M.A.
• Sarah Elyse Bolander, OTR/L
• Mary Claire Bombard, M.A.
• Barbara L Bonney, RNCS LIP
• Sarah Booker
• Heather Anne Bourdeau, O.D.
• Kristin M Bradley, DMD
• Abigail Sue Breen, LADC
• Deborah Ann Bristol, PA-C
• James Bromwell, DC

• All providers in White River Junction, VT
• Psychologist in Vermont

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2026; 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.