Soul Discovery Mental Health Counseling Services PC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Legal business name

SOUL DISCOVERY MENTAL HEALTH COUNSELING SERVICES PC

Practice address

333 Hempstead Ave Ste 203
Malverne, NY 11565-1242

Phone

(347) 344-0378

NPI assigned

Jul 24, 2020

Organization subpart

No

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

Authorized official

Name

Mrs. Glenda Momrelle-ClarkeNPI 1366873069

Title

Director/Owner

Phone

(347) 344-0378

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Glenda Momrelle-Clarke, MHC

  • Mental Health Counselor
  • Malverne, NY
  • NPI 1366873069
  Medicare reassignment NPD Authorized official
• Stephanie Bratton

  • Mental Health Counselor
  • Malverne, NY
  • NPI 1942031125
  NPD
• Robert Abbot, L.C.S.W.

  • Clinical Social Worker
  • Malverne, NY
  • NPI 1164870044
  NPD (past)
• Melanie Kaplan, MHC-LP, CASAC-P

  • Mental Health Counselor
  • Malverne, NY
  • NPI 1962249862
  NPD (past)

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

{
    "created_epoch": "1595548800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1595548800000",
    "number": "1003425299",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "333 HEMPSTEAD AVE STE 203",
            "city": "MALVERNE",
            "state": "NY",
            "postal_code": "115651242",
            "telephone_number": "347-344-0378"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "333 HEMPSTEAD AVE STE 203",
            "city": "MALVERNE",
            "state": "NY",
            "postal_code": "115651242",
            "telephone_number": "347-344-0378"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUL DISCOVERY MENTAL HEALTH COUNSELING SERVICES PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-07-24",
        "last_updated": "2020-07-24",
        "certification_date": "2020-07-24",
        "status": "A",
        "authorized_official_last_name": "MOMRELLE-CLARKE",
        "authorized_official_first_name": "GLENDA",
        "authorized_official_title_or_position": "DIRECTOR/OWNER",
        "authorized_official_telephone_number": "347-344-0378",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Patricia Ann Sullivan, ANP/FNP

• Mental Health Counselor in Malverne, NY
• Providers in Malverne, NY by specialty
• Mental Health Counselor in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.