Individual provider Active NPI

Jake Santilli, LMHC

  • Mental Health Counselor
  • Morrisonville, NY
National Provider Identifier
1003467309
Registry record updated Sep 27, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
102877-01 Issued in NY
Practice address
2155 Route 22B
Morrisonville, NY 12962-3417
Phone
(518) 563-8000
NPI assigned
Sep 27, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 27, 2019

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 102877-01 NY Primary

Addresses

Primary practice location

2155 Route 22B
Morrisonville, NY 12962-3417

Mailing address

2155 Route 22B
Morrisonville, NY 12962-3417
Phone (518) 563-8000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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 1

Enrollment IDStateProvider typePAC IDDetails
I20240129004074 NY Practitioner - Mental Health Counselor 3375996036 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Post Graduate Center for Mental HealthGroup PAC ID 9537050729, 15 clinicians

Practice addresses (Care Compare)

134 E 177TH St
Bronx, NY 10453-5902
Phone (212) 665-1860

213 W 35TH St
RM 403
New York, NY 10001-0215
Phone (212) 576-4104

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
102877-01NYMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Postgraduate Center for Mental Health CurrentSince Mar 15, 2025 Accepting new patients
Behavioral Health Services North, Inc. CurrentSince Jan 1, 2024 Accepting new patients
Behavioral Health Services North, Inc. CurrentSince Jan 1, 2024 Accepting new patients

Locations

2155 State Route 22B
Morrisonville, NY 12962
Phone (518) 562-3847

158 E 35th St
New York, NY 10016
Phone (212) 576-4104

22 US Oval
Ste 218
Plattsburgh, NY 12903
Phone (518) 534-9666

Organizations & group practices 3

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": "1569542400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1569542400000",
    "number": "1003467309",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2155 ROUTE 22B",
            "city": "MORRISONVILLE",
            "state": "NY",
            "postal_code": "129623417",
            "telephone_number": "518-563-8000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2155 ROUTE 22B",
            "city": "MORRISONVILLE",
            "state": "NY",
            "postal_code": "129623417",
            "telephone_number": "518-563-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANTILLI",
        "first_name": "JAKE",
        "credential": "LMHC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-09-27",
        "last_updated": "2019-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NY",
            "license": "102877-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Morrisonville, NY

Sources for this page

Verify at the official NPI Registry.