Individual provider Active NPI

Nicholas Smith, LMHC

  • Mental Health Counselor
  • Rockville Centre, NY
National Provider Identifier
1043762586
Registry record updated Aug 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
007113 Issued in NY
Practice address
119 N Park Ave Ste 306
Rockville Centre, NY 11570-4113
Phone
(516) 208-3792
NPI assigned
Nov 1, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 11, 2022

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 007113 NY Primary

Addresses

Primary practice location

119 N Park Ave Ste 306
Rockville Centre, NY 11570-4113

Mailing address

6649 Colonial Rd Apt 1
Brooklyn, NY 11220-4833
Phone (646) 505-7821

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
007113NYMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Triangle Cognitive Therapy, LCSW, PLLC CurrentSince Aug 14, 2022 Accepting new patients

Locations

119 N Park Ave
Ste 306
Rockville Centre, NY 11570
Phone (516) 208-3792

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1477958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660176000000",
    "number": "1043762586",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6649 COLONIAL RD APT 1",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112204833",
            "telephone_number": "646-505-7821"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "119 N PARK AVE STE 306",
            "city": "ROCKVILLE CENTRE",
            "state": "NY",
            "postal_code": "115704113",
            "telephone_number": "516-208-3792"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "NICHOLAS",
        "credential": "LMHC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-11-01",
        "last_updated": "2022-08-11",
        "certification_date": "2022-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NY",
            "license": "007113",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockville Centre, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2022; 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.