Individual provider Active NPI

Veronica Klimek, CASAC-T

  • Addiction (Substance Use Disorder) Counselor
  • Commack, NY
National Provider Identifier
1023414307
Registry record updated Nov 13, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
30670 Issued in NY
Practice address
155 Indian Head Rd
Commack, NY 11725-2212
Phone
(631) 723-3362
NPI assigned
Nov 13, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 13, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 30670 NY Primary

Addresses

Primary practice location

155 Indian Head Rd
Commack, NY 11725-2212

Mailing address

165 Patchogue Yaphank Rd
Yaphank, NY 11980-9626
Phone (631) 642-0170

Other identifiers 1

IdentifierTypeStateIssuer
30670OtherNYOASAS CERTIFICATE

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
30670NYMDAddiction (Substance Use Disorder) Counselor

NPI Registry JSON

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

{
    "created_epoch": "1415836800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1415836800000",
    "number": "1023414307",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "165 PATCHOGUE YAPHANK RD",
            "city": "YAPHANK",
            "state": "NY",
            "postal_code": "119809626",
            "telephone_number": "631-642-0170"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "155 INDIAN HEAD RD",
            "city": "COMMACK",
            "state": "NY",
            "postal_code": "117252212",
            "telephone_number": "631-723-3362"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KLIMEK",
        "first_name": "VERONICA",
        "credential": "CASAC-T",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-11-13",
        "last_updated": "2014-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NY",
            "license": "30670",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OASAS CERTIFICATE",
            "identifier": "30670",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Commack, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2014; 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.