Individual provider Active NPI

Bonnie F Kotkin, MA, LMHC

  • Mental Health Counselor
  • Patchogue, NY
National Provider Identifier
1124469150
Registry record updated Jul 6, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
005520 Issued in NY
Practice address
475 E Main St
Suite 200
Patchogue, NY 11772-3121
Phone
(516) 909-6850
NPI assigned
Jul 6, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 6, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 005520 NY Primary

Addresses

Primary practice location

475 E Main St
Suite 200
Patchogue, NY 11772-3121

Mailing address

85 Old Brook Rd
Dix Hills, NY 11746-6429
Phone (516) 909-6850

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Arts

NPI Registry JSON

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

{
    "created_epoch": "1373068800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1373068800000",
    "number": "1124469150",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "85 OLD BROOK RD",
            "city": "DIX HILLS",
            "state": "NY",
            "postal_code": "117466429",
            "telephone_number": "516-909-6850"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "475 E MAIN ST",
            "address_2": "SUITE 200",
            "city": "PATCHOGUE",
            "state": "NY",
            "postal_code": "117723121",
            "telephone_number": "516-909-6850"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOTKIN",
        "first_name": "BONNIE",
        "middle_name": "F",
        "name_prefix": "Mrs.",
        "credential": "MA, LMHC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-07-06",
        "last_updated": "2013-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NY",
            "license": "005520",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Patchogue, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 2013; 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.