NPIMap

Organization Active NPI

VA Medical Center Bath Ny

  • Intellectual & Developmental Disabilities Psychologist
  • Bath, NY
National Provider Identifier
1629097274
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual & Developmental Disabilities PsychologistTaxonomy code 103TM1800X
License
94-27P Issued in AR
Legal business name
VA MEDICAL CENTER BATH NY
Practice address
76 Veterans Ave
Behavioral Health Room 511D
Bath, NY 14810-0810
Phone
(607) 664-4305
NPI assigned
Jul 18, 2006
Last updated
Sep 11, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Authorized official

Name
Dr. Mark W Lawson, PH.D.NPI 1073620944
Title
Clinical Psychologist
Phone
(607) 664-4305

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 94-27P AR
Addiction (Substance Use Disorder) Psychologist 103TA0400X 94-27P AR
Cognitive & Behavioral Psychologist 103TB0200X 94-27P AR
Clinical Psychologist 103TC0700X 94-27P AR
Intellectual & Developmental Disabilities Psychologist 103TM1800X 94-27P AR Primary
Group Psychotherapy Psychologist 103TP2701X 94-27P AR

Addresses

Primary practice location

76 Veterans Ave
Behavioral Health Room 511D
Bath, NY 14810-0810

Mailing address

104 Texas LN
Ithaca, NY 14850-1755
Phone (607) 319-0929

National Provider Directory

National Provider Directory
Tax ID family
Buffalo Vamc61 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Locations

76 Veterans Ave
Rm 511D
Bath, NY 14810
Phone (607) 664-4305

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1153180800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757548800000",
    "number": "1629097274",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "104 TEXAS LN",
            "city": "ITHACA",
            "state": "NY",
            "postal_code": "148501755",
            "telephone_number": "607-319-0929"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "76 VETERANS AVE",
            "address_2": "BEHAVIORAL HEALTH ROOM 511D",
            "city": "BATH",
            "state": "NY",
            "postal_code": "148100810",
            "telephone_number": "607-664-4305"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VA MEDICAL CENTER BATH NY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-18",
        "last_updated": "2025-09-11",
        "status": "A",
        "authorized_official_last_name": "LAWSON",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "CLINICAL PSYCHOLOGIST",
        "authorized_official_telephone_number": "607-664-4305",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "AR",
            "license": "94-27P",
            "primary": false
        },
        {
            "code": "103TA0400X",
            "taxonomy_group": "",
            "desc": "Psychologist, Addiction (Substance Use Disorder)",
            "state": "AR",
            "license": "94-27P",
            "primary": false
        },
        {
            "code": "103TB0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Cognitive & Behavioral",
            "state": "AR",
            "license": "94-27P",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "AR",
            "license": "94-27P",
            "primary": false
        },
        {
            "code": "103TM1800X",
            "taxonomy_group": "",
            "desc": "Psychologist, Intellectual & Developmental Disabilities",
            "state": "AR",
            "license": "94-27P",
            "primary": true
        },
        {
            "code": "103TP2701X",
            "taxonomy_group": "",
            "desc": "Psychologist, Group Psychotherapy",
            "state": "AR",
            "license": "94-27P",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bath, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; 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.