Elizabeth A. Donovan, PH.D.

Primary specialty

PsychologistTaxonomy code 103T00000X

License

021477 Issued in NY

Practice address

124 E 84TH St Apt 1B
New York, NY 10028-0917

Phone

(917) 475-6726

NPI assigned

Dec 22, 2008

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• Ms. Elizabeth A. Omar Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Mar 3, 2025 through Mar 3, 2027

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": "1229904000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666051200000",
    "number": "1255577201",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "124 E 84TH ST APT 1B",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100280917",
            "telephone_number": "917-475-6726"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "124 E 84TH ST APT 1B",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100280917",
            "telephone_number": "917-475-6726"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DONOVAN",
        "first_name": "ELIZABETH",
        "middle_name": "A.",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-12-22",
        "last_updated": "2022-10-18",
        "certification_date": "2022-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TS0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, School",
            "state": "NY",
            "license": "872574",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NY",
            "license": "021477",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ELIZABETH",
            "last_name": "OMAR",
            "middle_name": "A.",
            "prefix": "MS.",
            "credential": "M.S.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Casey M Donovan, PA-C
• Christine Donovan, MSOT
• Daniel S. Donovan Jr., MD, MS
• Deirdre Hennigan Donovan, MA CCC/SLP
• Denis Joseph Donovan II, M.D.
• Haylee Sara Donovan, LCSW, SAP, CEAP,
• Joseph Charles Donovan, DNP, PMHNP-BC
• Katherine Frances Donovan, MD
• Kerryann Kathryn Donovan, NP
• Kirsten Donovan

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.