Individual provider Active NPI

Denise Syndee Wittlin-Horvath, LCSW-R, RN, NPP

  • Psychiatric/Mental Health Nurse Practitioner
  • Ithaca, NY
National Provider Identifier
1417006818
Registry record updated Mar 10, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
F40117-1 Issued in NY
Practice address
108 S Albany St
Suite 1a
Ithaca, NY 14850-5446
Phone
(607) 256-1167
NPI assigned
Jan 9, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 10, 2008

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 069855 NY
Registered Nurse 163W00000X 568571 NY
Psychiatric/Mental Health Nurse Practitioner 363LP0808X F40117-1 NY Primary

Addresses

Primary practice location

108 S Albany St
Suite 1a
Ithaca, NY 14850-5446

Mailing address

108 S Albany St
Suite 1a
Ithaca, NY 14850-5446
Phone (607) 256-1167

Other identifiers 3

IdentifierTypeStateIssuer
069855OtherNYLCSW
40117-1OtherNYNURSE PRACTITIONER PSYCH
568571OtherNYLIC. PROF. NURSE

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)
Enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
568571NYMDRegistered Nurse
069855NYMDPharmacist
F40117-1NYMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Denise S. Wittlin-Horvath Licensed Clinical Social Worker, PLLC Clinical Past Accepting new patients
Family & Children'S Service of Ithaca Inc PastSince Jan 1, 1992 Accepting new patients
Denise S. Wittlin-Horvath Psychiatric Nurse Practitioner, PLLC Psychiatric/Mental Health Past Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1168300800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1205107200000",
    "number": "1417006818",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "108 S ALBANY ST",
            "address_2": "SUITE 1A",
            "city": "ITHACA",
            "state": "NY",
            "postal_code": "148505446",
            "telephone_number": "607-256-1167"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "108 S ALBANY ST",
            "address_2": "SUITE 1A",
            "city": "ITHACA",
            "state": "NY",
            "postal_code": "148505446",
            "telephone_number": "607-256-1167"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WITTLIN-HORVATH",
        "first_name": "DENISE",
        "middle_name": "SYNDEE",
        "credential": "LCSW-R, RN, NPP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-09",
        "last_updated": "2008-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "069855",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "568571",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NY",
            "license": "F40117-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LCSW",
            "identifier": "069855",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NURSE PRACTITIONER PSYCH",
            "identifier": "40117-1",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LIC. PROF. NURSE",
            "identifier": "568571",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ithaca, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2008; 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.