Walter Wade Botkin III, LMHC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

MH9485 Issued in FL

Practice address

2650 Bahia Vista St
Suite 106
Sarasota, FL 34239-2635

Phone

(941) 812-5321

NPI assigned

Jun 18, 2008

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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.

• Touchstone Wellness Institute LLC

  • Community/Behavioral Health Agency
  • Sarasota, FL
  • NPI 1639339898
  NPD (past) Authorized official

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

{
    "created_epoch": "1213747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1463529600000",
    "number": "1114188554",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2650 BAHIA VISTA ST",
            "address_2": "SUITE 106",
            "city": "SARASOTA",
            "state": "FL",
            "postal_code": "342392635",
            "telephone_number": "941-812-5321"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2650 BAHIA VISTA ST",
            "address_2": "SUITE 106",
            "city": "SARASOTA",
            "state": "FL",
            "postal_code": "342392635",
            "telephone_number": "941-812-5321"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOTKIN",
        "first_name": "WALTER",
        "middle_name": "WADE",
        "name_prefix": "Mr.",
        "name_suffix": "III",
        "credential": "LMHC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-06-18",
        "last_updated": "2016-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH9485",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD OF FLORIDA",
            "identifier": "Z167Y",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Dirk Boschen, LCSW
• Kinshuk Bose, MD
• Taylor Bosnick
• Myrna Zoe Bosques-Torrens, M.D.
• Kimberly Bothwell, DC
• Nermeen Botrs, RPH
• Lisa Marie Botticelli, PH.D.
• Randi Botwinick
• Marvin D Bouchon, RPH
• Miroslava Plamenova Bounardjieva, DMD

• Mental Health Counselor in Sarasota, FL
• Providers in Sarasota, FL by specialty
• Mental Health Counselor in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2016; 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.