VA MEDICAL CENTER BATH NY NPI 1629097274

NPI Information

  • NPI: 1629097274
  • Provider Name: VA MEDICAL CENTER BATH NY
  • Classification: Psychologist - 103TA0400X
  • Specialization: Addiction (Substance Use Disorder)
  • Entity Type: Organization
  • Address: 76 VETERANS AVE
    BEHAVIORAL HEALTH ROOM 511D
    BATH, NY
    ZIP 14810
  • Phone: (607) 664-4305

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NPI Details

VA MEDICAL CENTER BATH NY is an addiction (substance use disorder) psychologist in Bath, NY. The provider is a psychologist with a proficiency that involves the application of psychological treatment of addiction stemming from the use of alcohol and other psychoactive substances (e.g., nicotine, marijuana, cocaine, heroin) or behavioral addictions (e.g., gambling) with the aim of cessation or reduction of use and/or the amelioration of emotional, behavioral, interpersonal and other problems arising from the addictive behavior. VA MEDICAL CENTER BATH NY NPI is 1629097274. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

76 VETERANS AVE
BEHAVIORAL HEALTH ROOM 511D
BATH, NY
ZIP 14810-810
Phone: (607) 664-4305

The provider's authorized official is Mark W Lawson .
The authorized official title is Clinical Psychologist and has the following contact phone number (607) 664-4305.

The enumeration date for this NPI number is 7/18/2006 and was last updated on 8/22/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1103TA0400XPsychologistAddiction (Substance Use Disorder)94-27PARKANSASYes
2103TB0200XPsychologistCognitive & Behavioral94-27PARKANSASX
3103TC0700XPsychologistClinical94-27PARKANSASX
4103TM1800XPsychologistIntellectual and Developmental Disabilities94-27PARKANSASX
5103T00000XPsychologist94-27PARKANSASX
6103TP2701XPsychologistGroup Psychotherapy94-27PARKANSASX

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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