Renee Licorish, DNP, APRN, PMHNP-BC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

405792 Issued in NY

Practice address

343 4TH Ave
Brooklyn, NY 11215-2719

Phone

(929) 470-9881

NPI assigned

Mar 13, 2019

Last updated

Dec 31, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Electronic endpoints 3

Medicare fee-for-service enrollment

Enrolled in TX, NY2 enrollments

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 2

Specialty

Nurse Practitioner

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Kings Physician Services PCGroup PAC ID 0547579427, 643 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• New York-Presbyterian Hospital Hospital, New York, NY, CCN 330101

Merit-based Incentive Payment System (MIPS)

Final score

94.47 of 100Reported as group

Quality

84.67

Promoting interoperability

100

Improvement activities

40

Cost

71.47

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Networks

• Healthfirst Medicare Network H5989
• Healthfirst Medicare Network H1722
• Healthfirst Medicare Network H9678
• Healthfirst Medicare Network H3359

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.

• Kings Physician Services, PC

  • Diagnostic Radiology Physician
  • Brooklyn, NY
  • NPI 1083045090
  Medicare reassignment Care Compare group NPD
• Mypsych Mental Health, PLLC

  • Psychiatry Physician
  • San Antonio, TX
  • NPI 1871962191
  Medicare reassignment NPD
• Mental Aspects Behavioral Health Clinic

  • Psychiatric/Mental Health Nurse Practitioner
  • Live Oak, TX
  • NPI 1760141733
  NPD (past) Authorized official
• Kings Physician Services, PC

  dba Kings Emergency Physician Services

  • Emergency Medicine Physician
  • Brooklyn, NY
  • NPI 1326698879
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• The New York and Presbyterian Hospital

  dba New York Presbyterian Hospital

  • General Acute Care Hospital
  • New York, NY
  • NPI 1144504044
  Care Compare affiliation
• The New York and Presbyterian Hospital

  dba New York-Presbyterian Hospital

  • Ambulance
  • New York, NY
  • NPI 1174628473

  Hospital

  Care Compare affiliation
• The New York and Presbyterian Hospital

  dba NewYork-Presbyterian Hospital

  • General Acute Care Hospital
  • New York, NY
  • NPI 1194832477
  Care Compare affiliation
• The New York and Presbyterian Hospital

  • General Acute Care Hospital
  • Bronxville, NY
  • NPI 1780196345
  Care Compare affiliation
• The New York and Presbyterian Hospital

  dba New York-Presbyterian Hospital

  • General Acute Care Hospital
  • New York, NY
  • NPI 1952332801
  Care Compare affiliation

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

{
    "created_epoch": "1552435200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735603200000",
    "number": "1437618097",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17460 I-35N",
            "address_2": "SUITE 430-419",
            "city": "SCHERTZ",
            "state": "TX",
            "postal_code": "78154",
            "telephone_number": "832-623-8131",
            "fax_number": "855-631-4341"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "343 4TH AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112152719",
            "telephone_number": "929-470-9881"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LICORISH",
        "first_name": "RENEE",
        "name_prefix": "Mrs.",
        "credential": "DNP, APRN, PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-03-13",
        "last_updated": "2024-12-31",
        "certification_date": "2024-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NY",
            "license": "405792",
            "primary": true
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TX",
            "license": "AP140787",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "hkc9004@direct.nyp.org",
            "affiliation": "N",
            "endpointDescription": "Direct Address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Direct Address",
            "address_1": "506 6th St",
            "city": "Brooklyn",
            "state": "NY",
            "country_code": "US",
            "postal_code": "112153609",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/R4/",
            "affiliation": "N",
            "endpointDescription": "FHIR",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "FHIR",
            "address_1": "506 6th St",
            "city": "Brooklyn",
            "state": "NY",
            "country_code": "US",
            "postal_code": "112153609",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/R4/",
            "affiliation": "N",
            "endpointDescription": "FHIR",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "FHIR",
            "address_1": "506 6th St",
            "city": "Brooklyn",
            "state": "NY",
            "country_code": "US",
            "postal_code": "112153609",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Jacob Lichtman
• Rifky Lichtman, LBA,BCBA
• Ronnie Sue Lichtman, CNM, PHD, FACNM
• Tamar Lichtman, LCSW
• Yechiel Lichtman
• Anne Liddell, ATR-BC, LCAT
• Howard A Liddle, EDD
• Madison Liddle
• Tara Jeanne Liddle, P.T. M.A.
• Maksym Lider, LMHC

• Psychiatric/Mental Health Nurse Practitioner in Brooklyn, NY
• Providers in Brooklyn, NY by specialty
• Psychiatric/Mental Health Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 31, 2024; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.