Organization
VA MEDICAL CENTER BATH NY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARK W LAWSON PH.D. (CLINICAL PSYCHOLOGIST)
(607) 664-4305
Entity
Organization
Contact information
Practice address
76 VETERANS AVE, BEHAVIORAL HEALTH ROOM 511D, BATH, NY 14810-0810
(607) 664-4305
Mailing address
104 TEXAS LN, ITHACA, NY 14850-1755
(607) 319-0929
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
94-27P
AR
103TA0400X
Addiction (Substance Use Disorder) Psychologist
94-27P
AR
103TB0200X
Cognitive & Behavioral Psychologist
94-27P
AR
103TC0700X
Clinical Psychologist
94-27P
AR
103TM1800X
Intellectual & Developmental Disabilities Psychologist
Primary
94-27P
AR
103TP2701X
Group Psychotherapy Psychologist
94-27P
AR
Other
Enumeration date
07/18/2006
Last updated
09/11/2025
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