Meredith Bodenstab, LCSW

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

080614 Issued in NY

Practice address

358 Homan Rd
Stanfordville, NY 12581-6036

Phone

(845) 868-7451

NPI assigned

Jun 25, 2013

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• On-Site Psychological Services PC

  • Clinical Psychologist
  • Ridgefield, CT
  • NPI 1992807887
  NPD (past)

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

{
    "created_epoch": "1372118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1487980800000",
    "number": "1295175107",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "358 HOMAN RD",
            "city": "STANFORDVILLE",
            "state": "NY",
            "postal_code": "125816036",
            "telephone_number": "845-868-7451"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "358 HOMAN RD",
            "city": "STANFORDVILLE",
            "state": "NY",
            "postal_code": "125816036",
            "telephone_number": "845-868-7451"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BODENSTAB",
        "first_name": "MEREDITH",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-06-25",
        "last_updated": "2017-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "080614",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Angelo a Della Pietra Family Medical PC
• Juliet Bruce
• Tayaisha Burton
• Natasha Crawford, LPN
• Angelo Anthony Della Pietra, MD, DO
• Deborah Dipalma-Wells, M.A. OTR/L

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.