Individual provider Active NPI

Lee Wesson Odescalchi, PHD

  • Psychologist
  • Poughkeepsie, NY
National Provider Identifier
1942386271
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
013095-1 Issued in NY
Practice address
24 Davis Ave
Poughkeepsie, NY 12603
Phone
(845) 505-7495
Fax
(845) 635-2283
NPI assigned
Oct 30, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 013095-1 NY Primary

Addresses

Primary practice location

24 Davis Ave
Poughkeepsie, NY 12603

Mailing address

24 Davis Avenue
Poughkeepsie, NY 12603
Phone (845) 505-7495

Other identifiers 5

IdentifierTypeStateIssuer
417844OtherMVP HEALTH CARE
734933OtherVALUEOPTIONS
7908540OtherAETNA
137407OtherVALUEOPTIONS
7349337OtherVALUEOPTIONS

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
013095-1NYMDPsychologist

NPI Registry JSON

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

{
    "created_epoch": "1162166400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1942386271",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24 DAVIS AVENUE",
            "city": "POUGHKEEPSIE",
            "state": "NY",
            "postal_code": "12603",
            "telephone_number": "845-505-7495",
            "fax_number": "845-635-2283"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24 DAVIS AVE",
            "city": "POUGHKEEPSIE",
            "state": "NY",
            "postal_code": "12603",
            "telephone_number": "845-505-7495",
            "fax_number": "845-635-2283"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ODESCALCHI",
        "first_name": "LEE",
        "middle_name": "WESSON",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-30",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NY",
            "license": "013095-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MVP HEALTH CARE",
            "identifier": "417844",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VALUEOPTIONS",
            "identifier": "734933",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7908540",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VALUEOPTIONS",
            "identifier": "137407",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VALUEOPTIONS",
            "identifier": "7349337",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Poughkeepsie, NY

Sources for this page

  • 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.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.