Laura Boekman Bologh, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

014452 Issued in NY

Practice address

45 Popham Rd
1H
Scarsdale, NY 10583-4252

Phone

(914) 725-3545

NPI assigned

Nov 3, 2006

Sex

Female

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

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Apr 5, 2017 through Apr 5, 2027

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

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

{
    "created_epoch": "1162512000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1831278696",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6 PERTH AVE",
            "city": "NEW ROCHELLE",
            "state": "NY",
            "postal_code": "108043519",
            "telephone_number": "914-632-4488"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "45 POPHAM RD",
            "address_2": "1H",
            "city": "SCARSDALE",
            "state": "NY",
            "postal_code": "105834252",
            "telephone_number": "914-725-3545"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOLOGH",
        "first_name": "LAURA",
        "middle_name": "BOEKMAN",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "014452",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• David Bloomgarden, MD
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• Helen Bores
• Suzanne Bouchard, LMHC
• Kristi Marie Bracchitta, PH.D.

• Clinical Psychologist in Scarsdale, NY
• Providers in Scarsdale, 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 Jul 8, 2007; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.