Individual provider Active NPI

Dawn Maria Lotter-Griffin, PH.D.

  • Clinical Psychologist
  • Brooklyn, NY
National Provider Identifier
1275671075
Registry record updated Feb 23, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
015783-1 Issued in NY
Practice address
3512 Quentin Rd
Brooklyn, NY 11234-4231
Phone
(718) 854-8370
Fax
(718) 854-8308
NPI assigned
Feb 2, 2007
Last updated
Feb 23, 2011By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 23, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 20042115A IN
Clinical Psychologist 103TC0700X 015783-1 NY Primary

Addresses

Primary practice location

3512 Quentin Rd
Brooklyn, NY 11234-4231

Mailing address

3512 Quentin Rd
Brooklyn, NY 11234-4231
Phone (718) 854-8370

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
I20050318000858 NY Practitioner - Clinical Psychologist 7214982586 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
20042115AINMDClinical Psychologist
015783-1NYMDClinical Psychologist
015783NYMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Che Senior Psychological Services, PC Clinical CurrentSince Mar 1, 2011 Accepting new patients
Knapp Street Psychiatry, PC Clinical CurrentSince Mar 1, 2011 Accepting new patients
Clinical Psychassociates LLP Clinical Past Accepting new patients

Locations

1915 Ocean Ave
Brooklyn, NY 11230
Phone (718) 258-7700

250 Beach 17th St
Far Rockaway, NY 11691
Phone (516) 670-0212

209 Beach 125th St
Rockaway Park, NY 11694
Phone (516) 721-7625

135 Vanderbilt Ave
Staten Island, NY 10304
Phone (718) 447-0101

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1170374400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1298419200000",
    "number": "1275671075",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3512 QUENTIN RD",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112344231",
            "telephone_number": "718-854-8370",
            "fax_number": "718-854-8308"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3512 QUENTIN RD",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112344231",
            "telephone_number": "718-854-8370",
            "fax_number": "718-854-8308"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOTTER-GRIFFIN",
        "first_name": "DAWN",
        "middle_name": "MARIA",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-02",
        "last_updated": "2011-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IN",
            "license": "20042115A",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "015783-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.