Individual provider Active NPI

Joanna Novakovic, MFT-LP

  • Marriage & Family Therapist
  • Cortland, NY
National Provider Identifier
1962767079
Registry record updated Jul 23, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
P88530 Issued in NY
Practice address
10 N Main St
Cortland, NY 13045-2130
Phone
(607) 753-0234
Fax
(607) 753-0286
NPI assigned
Jul 5, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X P88530 NY Primary

Addresses

Primary practice location

10 N Main St
Cortland, NY 13045-2130

Mailing address

10 N Main St
Cortland, NY 13045-2130
Phone (607) 753-0234

Other identifiers 1

IdentifierTypeStateIssuer
1336163963MedicaidNY

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

State licenses

LicenseStateTypeSpecialty
P88530NYMDMarriage & Family Therapist

NPI Registry JSON

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

{
    "created_epoch": "1341446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1374537600000",
    "number": "1962767079",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 N MAIN ST",
            "city": "CORTLAND",
            "state": "NY",
            "postal_code": "130452130",
            "telephone_number": "607-753-0234",
            "fax_number": "607-753-0286"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 N MAIN ST",
            "city": "CORTLAND",
            "state": "NY",
            "postal_code": "130452130",
            "telephone_number": "607-753-0234",
            "fax_number": "607-753-0286"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NOVAKOVIC",
        "first_name": "JOANNA",
        "credential": "MFT-LP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-07-05",
        "last_updated": "2013-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "NY",
            "license": "P88530",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1336163963",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cortland, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2013; 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.