Individual provider Active NPI

Chelsea Phillips

  • Mental Health Counselor
  • Great Neck, NY
National Provider Identifier
1003407560
Registry record updated Jan 28, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
800 Northern Blvd
Great Neck, NY 11021-5340
Phone
(516) 829-9666
NPI assigned
Jan 28, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 28, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X Primary

Addresses

Primary practice location

800 Northern Blvd
Great Neck, NY 11021-5340

Mailing address

14202 20TH Ave
Flushing, NY 11351-3000
Phone (347) 542-5615

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, MD2 enrollments
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.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20241204002190 DC Practitioner - Mental Health Counselor 5294261061 Reassigns benefits to 1 organization
I20241204002735 MD Practitioner - Mental Health Counselor 5294261061 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Luminis Health Medical Group, LLCGroup PAC ID 2860447315, 540 clinicians

Practice addresses (Care Compare)

4175 N Hanson Court
201 Luminis Health Breast Center of Bowie
Bowie, MD 20716-3181
Phone (443) 481-5300

4175 N Hanson CT
Bowie, MD 20716-3181

8200 Good Luck Rd
Lanham, MD 20706-3511
Phone (301) 623-4350

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Luminis Health Medical Group, LLC Current Accepting new patients
Luminis Health Medical Group, LLC CurrentSince Nov 18, 2024 Accepting new patients
Luminis Health Medical Group, LLC CurrentSince Nov 18, 2024 Accepting new patients
Luminis Health Medical Group, LLC CurrentSince Nov 18, 2024 Accepting new patients
Luminis Health Medical Group, LLC Current Accepting new patients

Locations

2003 Medical Pkwy
Ste 301
Annapolis, MD 21401
Phone (443) 481-3366

2000 Medical Pkwy
Ste 409
Annapolis, MD 21401
Phone (443) 481-5136

4175 N Hanson Ct
Ste 201
Bowie, MD 20716
Phone (443) 481-1199

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1611792000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611792000000",
    "number": "1003407560",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14202 20TH AVE",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113513000",
            "telephone_number": "347-542-5615"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 NORTHERN BLVD",
            "city": "GREAT NECK",
            "state": "NY",
            "postal_code": "110215340",
            "telephone_number": "516-829-9666"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHILLIPS",
        "first_name": "CHELSEA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-01-28",
        "last_updated": "2021-01-28",
        "certification_date": "2021-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Great Neck, NY

Sources for this page

Verify at the official NPI Registry.