Active NPI
Lawrence Robert Kotkin, PHD
- Clinical Psychologist
- Melville, NY
National Provider Identifier
1982789970
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 6339
- Practice address
- 61 Wilmington Dr
Melville, NY 11747-4032 - Phone
- (631) 643-0924
- Fax
- (631) 491-9110
- NPI assigned
- Oct 26, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Cognitive & Behavioral Psychologist | 103TB0200X | 6339 | NY | |
| Clinical Psychologist | 103TC0700X | 6339 | NY | Primary |
| Family Psychologist | 103TF0000X | 6339 | NY | |
| Psychologist | 103T00000X | 6339 | NY |
Addresses
Primary practice location
61 Wilmington Dr
Melville, NY 11747-4032
Mailing address
61 Wilmington Dr
Melville, NY 11747-4032
Phone (631) 643-0924
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 87726 | Other | NY | UNITED BEHAVIORAL HEALTH |
| 087600 | Other | NY | VALUE OPTIONS |
| 35296 | Other | NY | VYTRA BEHAVIORAL HEALTH |
| AS217 | Other | NY | OXFORD HEALTH PLANS |
| 104024000 | Other | NY | MAGELLAN HEALTH PLANS |
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)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6339 | NY | MD | Family Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161820800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1263427200000",
"number": "1982789970",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "61 WILMINGTON DR",
"city": "MELVILLE",
"state": "NY",
"postal_code": "117474032",
"telephone_number": "631-643-0924",
"fax_number": "631-491-9110"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "61 WILMINGTON DR",
"city": "MELVILLE",
"state": "NY",
"postal_code": "117474032",
"telephone_number": "631-643-0924",
"fax_number": "631-491-9110"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KOTKIN",
"first_name": "LAWRENCE",
"middle_name": "ROBERT",
"name_prefix": "Dr.",
"credential": "PHD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-10-26",
"last_updated": "2010-01-14",
"status": "A"
},
"taxonomies": [
{
"code": "103TB0200X",
"taxonomy_group": "",
"desc": "Psychologist, Cognitive & Behavioral",
"state": "NY",
"license": "6339",
"primary": false
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "NY",
"license": "6339",
"primary": true
},
{
"code": "103TF0000X",
"taxonomy_group": "",
"desc": "Psychologist, Family",
"state": "NY",
"license": "6339",
"primary": false
},
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "NY",
"license": "6339",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED BEHAVIORAL HEALTH",
"identifier": "87726",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "VALUE OPTIONS",
"identifier": "087600",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "VYTRA BEHAVIORAL HEALTH",
"identifier": "35296",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "OXFORD HEALTH PLANS",
"identifier": "AS217",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MAGELLAN HEALTH PLANS",
"identifier": "104024000",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Melville, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.