Individual provider Active NPI

Miriam Rachel Osofsky, PH.D.

  • Clinical Psychologist
  • Lebanon, NH
National Provider Identifier
1407068976
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
692 Issued in NH
Practice address
367 State Route 120
Suite B-8
Lebanon, NH 03766-1430
Phone
(603) 443-0500
NPI assigned
May 4, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 692 NH Primary

Addresses

Primary practice location

367 State Route 120
Suite B-8
Lebanon, NH 03766-1430

Mailing address

2 Woodmore Dr
Hanover, NH 03755-1321
Phone (603) 643-1664

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

State licenses

LicenseStateTypeSpecialty
692NHMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1178236800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1407068976",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 WOODMORE DR",
            "city": "HANOVER",
            "state": "NH",
            "postal_code": "037551321",
            "telephone_number": "603-643-1664"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "367 STATE ROUTE 120",
            "address_2": "SUITE B-8",
            "city": "LEBANON",
            "state": "NH",
            "postal_code": "037661430",
            "telephone_number": "603-443-0500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OSOFSKY",
        "first_name": "MIRIAM",
        "middle_name": "RACHEL",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-04",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NH",
            "license": "692",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lebanon, NH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 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.