Individual provider Active NPI

Elizabeth Maria Botero, LMSW

  • Clinical Social Worker
  • Beacon, NY
National Provider Identifier
1386912772
Registry record updated Dec 13, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
051147-1 Issued in NY
Practice address
10 Education Dr
Beacon, NY 12508-4066
Phone
(845) 838-6900
Fax
(845) 838-6976
NPI assigned
Dec 13, 2011
Last updated
Dec 13, 2011By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 13, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 051147-1 NY Primary

Addresses

Primary practice location

10 Education Dr
Beacon, NY 12508-4066

Mailing address

619 Kissam Rd
Peekskill, NY 10566-2472
Phone (914) 844-4789

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

State licenses

LicenseStateTypeSpecialty
051147-1NYMDGeneral Practice Dentistry
051147NYMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Beacon City School District Past Accepting new patients

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, 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": "1323734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1323734400000",
    "number": "1386912772",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "619 KISSAM RD",
            "city": "PEEKSKILL",
            "state": "NY",
            "postal_code": "105662472",
            "telephone_number": "914-844-4789",
            "fax_number": "914-402-5473"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 EDUCATION DR",
            "city": "BEACON",
            "state": "NY",
            "postal_code": "125084066",
            "telephone_number": "845-838-6900",
            "fax_number": "845-838-6976"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOTERO",
        "first_name": "ELIZABETH",
        "middle_name": "MARIA",
        "name_prefix": "Ms.",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-12-13",
        "last_updated": "2011-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "051147-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Beacon, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2011; 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.