Active NPI
Deborah Christine Botnick-Basile, PSY.D.
- Clinical Psychologist
- New York, NY
National Provider Identifier
1568540888
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 68 017114
- Practice address
- 160 W 86TH St
New York, NY 10024-4018 - Phone
- (212) 362-8755
- NPI assigned
- Nov 2, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 68 017114 | NY | Primary |
Addresses
Primary practice location
160 W 86TH St
New York, NY 10024-4018
Mailing address
13 E Clinton Ave
Irvington, NY 10533-2308
Phone (914) 478-0568
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
| License | State | Type | Specialty |
|---|---|---|---|
| 68 017114 | NY | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1162425600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1184630400000",
"number": "1568540888",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "13 E CLINTON AVE",
"city": "IRVINGTON",
"state": "NY",
"postal_code": "105332308",
"telephone_number": "914-478-0568"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "160 W 86TH ST",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100244018",
"telephone_number": "212-362-8755"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOTNICK-BASILE",
"first_name": "DEBORAH",
"middle_name": "CHRISTINE",
"name_prefix": "Dr.",
"credential": "PSY.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-11-02",
"last_updated": "2007-07-17",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "NY",
"license": "68 017114",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in New York, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 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.