Individual provider Active NPI

Jonathan Charles Bannigan, MHC-LP

  • Mental Health Counselor
  • New York, NY
National Provider Identifier
1003413394
Registry record updated Oct 8, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
P107008 Issued in NY
Practice address
260 Madison Ave FL 8
New York, NY 10016-2418
Phone
(212) 335-0511
NPI assigned
Oct 8, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 8, 2020

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 P107008 NY Primary

Addresses

Primary practice location

260 Madison Ave FL 8
New York, NY 10016-2418

Mailing address

176 Glenwood Ave Apt 2R
Bloomfield, NJ 07003-2346
Phone (315) 335-0934

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
P107008NYMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Peaceful Way Psychology PLLC PastSince Dec 3, 2023 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1602115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602115200000",
    "number": "1003413394",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "176 GLENWOOD AVE APT 2R",
            "city": "BLOOMFIELD",
            "state": "NJ",
            "postal_code": "070032346",
            "telephone_number": "315-335-0934"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "260 MADISON AVE FL 8",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100162418",
            "telephone_number": "212-335-0511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BANNIGAN",
        "first_name": "JONATHAN",
        "middle_name": "CHARLES",
        "name_prefix": "Mr.",
        "credential": "MHC-LP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-10-08",
        "last_updated": "2020-10-08",
        "certification_date": "2020-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NY",
            "license": "P107008",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.