NPIMap

Organization Active NPI

My Therapist LCSW, PLLC

  • Community/Behavioral Health Agency
  • Bronx, NY
National Provider Identifier
1164624151
Registry record updated Dec 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
R048253-1 Issued in NY
Legal business name
MY THERAPIST LCSW, PLLC
Practice address
2880 Baisley Ave
Bronx, NY 10461-6117
Phone
(914) 734-2205
Fax
(914) 734-2203
NPI assigned
Jun 3, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 26, 2023

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

Authorized official

Name
Ms. Denise Dubose Foulkes, LCSWNPI 1902014194
Title
Psychotherapist Owner
Phone
(914) 734-2205

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
Community/Behavioral Health Agency 251S00000X R048253-1 NY Primary

Addresses

Primary practice location

2880 Baisley Ave
Bronx, NY 10461-6117

Mailing address

26 Sniffen Mountain Rd
Cortlandt Manor, NY 10567-6404
Phone (914) 734-2205

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190703001227 NY Part B Supplier - Clinic/Group Practice 9335473818 Receives reassigned benefits from 3 practitioners
Practice locations: Bronx, NY; Cortlandt Manor, NY; Yorktown Heights, NY

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 9

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": "1180828800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1703548800000",
    "number": "1164624151",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26 SNIFFEN MOUNTAIN RD",
            "city": "CORTLANDT MANOR",
            "state": "NY",
            "postal_code": "105676404",
            "telephone_number": "914-734-2205",
            "fax_number": "914-734-2203"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2880 BAISLEY AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104616117",
            "telephone_number": "914-734-2205",
            "fax_number": "914-734-2203"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MY THERAPIST LCSW, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-03",
        "last_updated": "2023-12-26",
        "certification_date": "2023-12-26",
        "status": "A",
        "authorized_official_last_name": "FOULKES",
        "authorized_official_first_name": "DENISE",
        "authorized_official_middle_name": "DUBOSE",
        "authorized_official_title_or_position": "PSYCHOTHERAPIST OWNER",
        "authorized_official_telephone_number": "914-734-2205",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NY",
            "license": "R048253-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 26, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.