Individual provider Active NPI

Lauree Wolin Mitchell, PH.D.

  • Clinical Psychologist
  • Brooklyn, NY
National Provider Identifier
1184725160
Registry record updated Aug 17, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
016345 Issued in NY
Practice address
34 Plaza St E
Ste 102
Brooklyn, NY 11238-5038
Phone
(718) 399-6852
NPI assigned
Sep 25, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 17, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 016345 NY Primary

Addresses

Primary practice location

34 Plaza St E
Ste 102
Brooklyn, NY 11238-5038

Mailing address

1 Plaza St W
Apt. #6a
Brooklyn, NY 11217-3748
Phone (718) 399-6852

Other names 1

  • Dr. Lauree Alice Wolin Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20061229000216 NY Practitioner - Clinical Psychologist 6507866308 Practice locations: Brooklyn, NY

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

34 Plaza E St
Suite 109
Brooklyn, NY 11238-5038
Phone (718) 399-6852

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

Practice roles

OrganizationSpecialtyStatusNew patients
LWM Mental Health Specialist LLC PastSince Aug 23, 2020 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1159142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597622400000",
    "number": "1184725160",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 PLAZA ST W",
            "address_2": "APT. #6A",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112173748",
            "telephone_number": "718-399-6852"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "34 PLAZA ST E",
            "address_2": "STE 102",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112385038",
            "telephone_number": "718-399-6852"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MITCHELL",
        "first_name": "LAUREE",
        "middle_name": "WOLIN",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-25",
        "last_updated": "2020-08-17",
        "certification_date": "2020-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "016345",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LAUREE",
            "last_name": "WOLIN",
            "middle_name": "ALICE",
            "prefix": "DR.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.