Lisa Marie Botticelli, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

025315 Issued in NY

Practice address

320 Central Ave Unit 311
Sarasota, FL 34236-5130

Phone

(203) 451-3100

NPI assigned

Sep 2, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

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 May 2, 2025 through May 2, 2027

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

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.

• Lisa Botticelli, PH.D. Psychology, P.L.L.C.

  • Clinical Psychologist
  • Brooklyn, NY
  • NPI 1407556822
  NPD Authorized official

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

{
    "created_epoch": "1630540800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721260800000",
    "number": "1992473961",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "320 CENTRAL AVE UNIT 311",
            "city": "SARASOTA",
            "state": "FL",
            "postal_code": "342365130",
            "telephone_number": "203-451-3100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "320 CENTRAL AVE UNIT 311",
            "city": "SARASOTA",
            "state": "FL",
            "postal_code": "342365130",
            "telephone_number": "203-451-3100"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 Chase Rd Ste 203",
            "address_purpose": "LOCATION",
            "city": "Scarsdale",
            "state": "NY",
            "postal_code": "105834160",
            "country_code": "US",
            "telephone_number": "917-620-8749",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOTTICELLI",
        "first_name": "LISA",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-09-02",
        "last_updated": "2024-07-18",
        "certification_date": "2024-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CT",
            "license": "4503",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "025315",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Taylor Bosnick
• Myrna Zoe Bosques-Torrens, M.D.
• Kimberly Bothwell, DC
• Walter Wade Botkin III, LMHC
• Nermeen Botrs, RPH
• Randi Botwinick
• Marvin D Bouchon, RPH
• Miroslava Plamenova Bounardjieva, DMD
• Ashley Bourcier
• Rene S Bourdeau, PT

• Clinical Psychologist in Sarasota, FL
• Providers in Sarasota, FL by specialty
• Clinical Psychologist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2024; 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.