Individual provider Active NPI

Mikita Brottman, PH.D, C.T.

  • Psychoanalyst
  • Baltimore, MD
National Provider Identifier
1265636567
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychoanalystTaxonomy code 102L00000X
Practice address
1 E Chase St
Belvedere Hotel, Suite #501
Baltimore, MD 21202-2526
Phone
(410) 385-0123
Fax
(410) 385-0123
NPI assigned
Jun 12, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychoanalyst 102L00000X Primary

Addresses

Primary practice location

1 E Chase St
Belvedere Hotel, Suite #501
Baltimore, MD 21202-2526

Mailing address

1 E Chase St
Belvedere Hotel, Suite #501
Baltimore, MD 21202-2526
Phone (410) 385-0123

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
Credentials
Doctor of Philosophy

NPI Registry JSON

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

{
    "created_epoch": "1181606400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1265636567",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 E CHASE ST",
            "address_2": "BELVEDERE HOTEL, SUITE #501",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212022526",
            "telephone_number": "410-385-0123",
            "fax_number": "410-385-0123"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 E CHASE ST",
            "address_2": "BELVEDERE HOTEL, SUITE #501",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212022526",
            "telephone_number": "410-385-0123",
            "fax_number": "410-385-0123"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROTTMAN",
        "first_name": "MIKITA",
        "name_prefix": "Dr.",
        "credential": "PH.D, C.T.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-06-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "102L00000X",
            "taxonomy_group": "",
            "desc": "Psychoanalyst",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.