Individual provider Active NPI

Howard Leibovitch, PH.D.

  • Clinical Psychologist
  • Goshen, NY
National Provider Identifier
1891885224
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
010213-41 Issued in NY
Practice address
3 Coates Dr
Suite 8
Goshen, NY 10924-6764
Phone
(845) 291-0999
Fax
(845) 294-8921
NPI assigned
Oct 14, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 010213-41 NY Primary

Addresses

Primary practice location

3 Coates Dr
Suite 8
Goshen, NY 10924-6764

Mailing address

3 Coates Dr
Suite 8
Goshen, NY 10924-6764
Phone (845) 291-0999

Other identifiers 1

IdentifierTypeStateIssuer
01554154MedicaidNY

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20111230000279 NY Practitioner - Clinical Psychologist 7719153428 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
010213-41NYMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Stress Reduction and Psychological Services, PC Clinical PastSince Nov 4, 2008 Accepting new patients

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1160784000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1891885224",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 COATES DR",
            "address_2": "SUITE 8",
            "city": "GOSHEN",
            "state": "NY",
            "postal_code": "109246764",
            "telephone_number": "845-291-0999",
            "fax_number": "845-294-8921"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 COATES DR",
            "address_2": "SUITE 8",
            "city": "GOSHEN",
            "state": "NY",
            "postal_code": "109246764",
            "telephone_number": "845-291-0999",
            "fax_number": "845-294-8921"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEIBOVITCH",
        "first_name": "HOWARD",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-14",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "010213-41",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01554154",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Goshen, NY

Sources for this page

Verify at the official NPI Registry.