Individual provider Active NPI

Lyanne Rachelle Yozawitz, PHD

  • Clinical Psychologist
  • Port Chester, NY
National Provider Identifier
1346917101
Registry record updated Nov 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
024730 Issued in NY
Practice address
10 Pearl St FL 2
Port Chester, NY 10573-4611
Phone
(914) 265-2762
Fax
(914) 653-8282
NPI assigned
Aug 27, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 11, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Neuropsychologist 103G00000X 024730 NY
Clinical Psychologist 103TC0700X 024730 NY Primary

Addresses

Primary practice location

10 Pearl St FL 2
Port Chester, NY 10573-4611

Mailing address

10 Pearl St FL 2
Port Chester, NY 10573-4611

Other practice location 1

1501 Broadway Ste 1505
New York, NY 10036-5505
Phone (845) 279-5908

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
I20220802002809 NY Practitioner - Clinical Psychologist 7517349954 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Carmel Psychological Health PCGroup PAC ID 4385530351, 222 clinicians

Practice addresses (Care Compare)

10 Pearl St
FL 2
Port Chester, NY 10573-4611
Phone (914) 265-2762

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
024730NYMDClinical Psychologist

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1630022400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731283200000",
    "number": "1346917101",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 PEARL ST FL 2",
            "city": "PORT CHESTER",
            "state": "NY",
            "postal_code": "105734611"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 PEARL ST FL 2",
            "city": "PORT CHESTER",
            "state": "NY",
            "postal_code": "105734611",
            "telephone_number": "914-265-2762",
            "fax_number": "914-653-8282"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1501 Broadway Ste 1505",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100365505",
            "country_code": "US",
            "telephone_number": "845-279-5908",
            "fax_number": "845-622-5055",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "YOZAWITZ",
        "first_name": "LYANNE",
        "middle_name": "RACHELLE",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-08-27",
        "last_updated": "2024-11-11",
        "certification_date": "2024-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "NY",
            "license": "024730",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "024730",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Chester, NY

Sources for this page

Verify at the official NPI Registry.