Traci Leigh Gavila, PSY.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

019442 Issued in NY

Practice address

220 S Buckhout St
Irvington, NY 10533-2206

Phone

(914) 200-3526

NPI assigned

Nov 9, 2012

Last updated

Sep 14, 2021By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1352419200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631577600000",
    "number": "1639423841",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "220 S BUCKHOUT ST",
            "city": "IRVINGTON",
            "state": "NY",
            "postal_code": "105332206",
            "telephone_number": "914-200-3526"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "220 S BUCKHOUT ST",
            "city": "IRVINGTON",
            "state": "NY",
            "postal_code": "105332206",
            "telephone_number": "914-200-3526"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "180 S BROADWAY",
            "address_2": "STE 207C",
            "address_purpose": "LOCATION",
            "city": "WHITE PLAINS",
            "state": "NY",
            "postal_code": "106051818",
            "country_code": "US",
            "telephone_number": "914-200-3526",
            "fax_number": "914-368-8721",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GAVILA",
        "first_name": "TRACI",
        "middle_name": "LEIGH",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-11-09",
        "last_updated": "2021-09-14",
        "certification_date": "2021-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "019442",
            "primary": true
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "NY",
            "license": "019442-1",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Linda Fleischman, L.C.S.W.
• Maria Foster
• Tracy Lorraine Franks, LCSW
• Lissi Garcia
• Richard Garner
• Brielle George
• Joseph Michael Giacomo, PT, DPT, ATC/L, CSCS
• Ushindi Cecile Gibson
• Heather Ann Goldman, PH.D.
• Johndavid Gonzalez, LCSW

• Clinical Psychologist in Irvington, NY
• Providers in Irvington, NY by specialty
• Clinical Psychologist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2021; 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.