Systemic Psychotherapy LCSW, PLLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

SYSTEMIC PSYCHOTHERAPY LCSW, PLLC

Doing business as

Systemic Psychotherapy Center

Practice address

420 Westchester Ave # 2B
Port Chester, NY 10573-3600

Phone

(203) 970-4738

NPI assigned

Aug 19, 2022

Organization subpart

Yes

Parent organization

SYSTEMIC PSYCHOTHERAPY, LLCAs reported in NPPES

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

Authorized official

Name

Andrea Ott, LCSWNPI 1568746188

Title

Owner and Founder

Phone

(203) 970-4738

Specialties & licenses 3

Addresses

Other identifiers 1

Other names 1

• Systemic Psychotherapy Center Doing business as

Electronic endpoints 1

Part of

Systemic Psychotherapy LLC

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Andrea De Ott, LCSW

  • Clinical Social Worker
  • Port Chester, NY
  • NPI 1568746188
  NPD Authorized official

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

{
    "created_epoch": "1660867200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1660867200000",
    "number": "1710605167",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "420 WESTCHESTER AVE # 2B",
            "city": "PORT CHESTER",
            "state": "NY",
            "postal_code": "105733600",
            "telephone_number": "203-970-4738"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "420 WESTCHESTER AVE # 2B",
            "city": "PORT CHESTER",
            "state": "NY",
            "postal_code": "105733600",
            "telephone_number": "203-970-4738"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SYSTEMIC PSYCHOTHERAPY LCSW, PLLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SYSTEMIC PSYCHOTHERAPY, LLC",
        "enumeration_date": "2022-08-19",
        "last_updated": "2022-08-19",
        "certification_date": "2022-08-19",
        "status": "A",
        "authorized_official_last_name": "OTT",
        "authorized_official_first_name": "ANDREA",
        "authorized_official_title_or_position": "OWNER AND FOUNDER",
        "authorized_official_telephone_number": "203-970-4738",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "06296166",
            "state": "NY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "www.appkareo.com",
            "affiliation": "N",
            "endpointDescription": "EHR",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "420 Westchester Ave # 2B",
            "city": "Port Chester",
            "state": "NY",
            "country_code": "US",
            "postal_code": "105733600",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Systemic Psychotherapy Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• David W Straut
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• Jeanine Sullivan, MSPT
• Sunlight Ambulette Inc
• Sunstar Mental Health Counseling Services PLLC
• Wojciech Szaniawski, MD
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• Puja Taneja, DDS
• Gregory Corino Tauro
• The Growth Garden Collective LLC

• Clinical Social Worker in Port Chester, NY
• Providers in Port Chester, NY by specialty
• Clinical Social Worker in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2022; 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.