Rischa Connell Gottlieb, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

021912 Issued in NY

Practice address

4807 30TH Ave
Apt 1
Astoria, NY 11103-1233

Phone

(917) 559-7209

NPI assigned

Oct 28, 2016

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other names 1

• Dr. Stephanie Rischa Gottlieb Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

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

{
    "created_epoch": "1477612800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1477612800000",
    "number": "1154873883",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4807 30TH AVE",
            "address_2": "APT 1",
            "city": "ASTORIA",
            "state": "NY",
            "postal_code": "111031233",
            "telephone_number": "917-559-7209"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4807 30TH AVE",
            "address_2": "APT 1",
            "city": "ASTORIA",
            "state": "NY",
            "postal_code": "111031233",
            "telephone_number": "917-559-7209"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOTTLIEB",
        "first_name": "RISCHA",
        "middle_name": "CONNELL",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-10-28",
        "last_updated": "2016-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TB0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Cognitive & Behavioral",
            "state": "NY",
            "license": "021912",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "021912",
            "primary": true
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "NY",
            "license": "021912",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "STEPHANIE",
            "last_name": "GOTTLIEB",
            "middle_name": "RISCHA",
            "prefix": "DR.",
            "credential": "PH.D",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Necias Gopico, RPT
• Christine Marie Gordon, LCSW
• Elizabeth Gordon, LMSW
• Ira Gornish, RPA
• Marina Mazianitou Gottfried, DDS, MS
• GR Transit Inc
• Valerie Graf, LCSW
• Tamicka Grant, RN
• Terry Gravesande, RPA
• Elizabeth Gray

• Clinical Psychologist in Astoria, NY
• Providers in Astoria, NY by specialty
• Clinical Psychologist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 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.