Individual provider Active NPI

Dorota Uzdawinis, PH.D., LMHC

  • Clinical Psychologist
  • Brooklyn, NY
National Provider Identifier
1770716854
Registry record updated May 14, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
021252 Issued in NY
Practice address
211 Greene Ave
Brooklyn, NY 11238-1221
Phone
(917) 771-3314
NPI assigned
Aug 24, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 14, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 004220 NY
Clinical Psychologist 103TC0700X 021252 NY Primary

Addresses

Primary practice location

211 Greene Ave
Brooklyn, NY 11238-1221

Mailing address

169 Adelphi St
Brooklyn, NY 11205-3301
Phone (917) 771-3314

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
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
004220NYMDAcupuncturist
021252NYMDMedical Physician Assistant

NPI Registry JSON

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

{
    "created_epoch": "1251072000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1589414400000",
    "number": "1770716854",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "169 ADELPHI ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112053301",
            "telephone_number": "917-771-3314"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "211 GREENE AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112381221",
            "telephone_number": "917-771-3314"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "UZDAWINIS",
        "first_name": "DOROTA",
        "name_prefix": "Dr.",
        "credential": "PH.D., LMHC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-08-24",
        "last_updated": "2020-05-14",
        "certification_date": "2020-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NY",
            "license": "004220",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "021252",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2020; 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.