Individual provider Active NPI

Laura Diskin Gottlieb, PSY.D.

  • Clinical Psychologist
  • Washington, DC
National Provider Identifier
1225655137
Registry record updated Feb 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY1001635 Issued in DC
Practice address
5335 Wisconsin Ave NW Ste 440
Washington, DC 20015-2079
Phone
(202) 540-8113
NPI assigned
Jun 26, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 4, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 0810006911 VA
Clinical Psychologist 103TC0700X 06409 MD
Clinical Psychologist 103TC0700X PSY1001635 DC Primary

Addresses

Primary practice location

5335 Wisconsin Ave NW Ste 440
Washington, DC 20015-2079

Mailing address

5335 Wisconsin Ave NW Ste 440
Washington, DC 20015-2079
Phone (202) 540-8113

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

State licenses

LicenseStateTypeSpecialty
PSY1001635DCMDClinical Psychologist
0810006911VAMDClinical Psychologist
06409MDMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Family Center Counseling Clinical PastSince Jun 1, 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": "1593129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738627200000",
    "number": "1225655137",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5335 WISCONSIN AVE NW STE 440",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200152079",
            "telephone_number": "202-540-8113"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5335 WISCONSIN AVE NW STE 440",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200152079",
            "telephone_number": "202-540-8113"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOTTLIEB",
        "first_name": "LAURA",
        "middle_name": "DISKIN",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-06-26",
        "last_updated": "2025-02-04",
        "certification_date": "2025-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "VA",
            "license": "0810006911",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MD",
            "license": "06409",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "DC",
            "license": "PSY1001635",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Washington, DC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2025; 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.