Bruce Gottlieb, PH D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PSY200001402 Issued in DC

Practice address

1732 15TH St NW
Washington, DC 20009-6642

Phone

(860) 818-4096

NPI assigned

Dec 12, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CT, DC2 enrollments

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 2

Specialty

Clinical Psychologist

Education

Other, 1980

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Pain Management Center of Farmington

  • Pain Clinic/Center
  • Farmington, CT
  • NPI 1730240854
  NPD (past) Authorized official

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

{
    "created_epoch": "1165881600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723939200000",
    "number": "1740341866",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1732 15TH ST NW",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200096642",
            "telephone_number": "860-818-4096"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1732 15TH ST NW",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200096642",
            "telephone_number": "860-818-4096"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOTTLIEB",
        "first_name": "BRUCE",
        "name_prefix": "Dr.",
        "credential": "PH D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-12",
        "last_updated": "2024-08-18",
        "certification_date": "2024-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "DC",
            "license": "PSY200001402",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Franca Ojezele Gotevbe
• Alita Gothard
• Lynne Gots, PHD
• Tinatin Gotsiridze, MD
• Brandy Gott, DPT
• Karen Schirm Gottlieb, MD
• Laura Diskin Gottlieb, PSY.D.
• Malca Rebeccah Gottlieb
• Sheldon Kenneth Gottlieb, MD, PHD
• Isabel C Gottron, MD

• Clinical Psychologist in Washington, DC
• Providers in Washington, DC by specialty
• Clinical Psychologist in District of Columbia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 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.