Michael Allen Boticki, PH.D.

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

40910900 Issued in WI

Practice address

1220 Mound Ave Ste 301
Racine, WI 53404-3350

Phone

(262) 633-3591

NPI assigned

Aug 5, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1154736000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1255340642",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7127 OLD SPRING ST",
            "city": "RACINE",
            "state": "WI",
            "postal_code": "534063304",
            "telephone_number": "262-456-0707"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1220 MOUND AVE STE 301",
            "city": "RACINE",
            "state": "WI",
            "postal_code": "534043350",
            "telephone_number": "262-633-3591"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOTICKI",
        "first_name": "MICHAEL",
        "middle_name": "ALLEN",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-05",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "WI",
            "license": "40910900",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "40910900",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Patricia S. Bolling, N.P.
• Glen Bordak, M.D.
• Craig John Borgardt, RPH
• Paige Borst
• Anna Marie Bort, LPN
• Roger O Boye, MD
• Katherine Braddock
• Pheynell Branch, AAS, CSAC,CSIT
• Wallace Edward Brandies Jr., CSAC ICS
• Michelle Braun, PHD

• Professional Counselor in Racine, WI
• Providers in Racine, WI by specialty
• Professional Counselor in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.