Individual provider Active NPI

Sophia A Dror, LBA, LMHC

  • Mental Health Counselor
  • Brooklyn, NY
National Provider Identifier
1053668368
Registry record updated Apr 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
2925A Kings Hwy
Brooklyn, NY 11229-1805
Phone
(718) 382-0045
Fax
(718) 859-7157
NPI assigned
Aug 7, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 12, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X 00234201 NY
Mental Health Counselor 101YM0800X Primary

Addresses

Primary practice location

2925A Kings Hwy
Brooklyn, NY 11229-1805

Mailing address

2925A Kings Hwy
Brooklyn, NY 11229-1805
Phone (718) 382-0045

Other names 1

  • Sophia Ariella Bailey Former name

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
I20241219002451 NY Practitioner - Mental Health Counselor 8527595263 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
00234201NYMDBehavioral Analyst

Practice roles

OrganizationSpecialtyStatusNew patients
Community Assistance Resources & Extended Services Inc CurrentSince Dec 1, 2024 Accepting new patients

Locations

465 Grand St
New York, NY 10002
Phone (212) 420-1970

Networks

  • Healthfirst Medicare Network H9678

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": "1344297600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681257600000",
    "number": "1053668368",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2925A KINGS HWY",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112291805",
            "telephone_number": "718-382-0045",
            "fax_number": "718-859-7157"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2925A KINGS HWY",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112291805",
            "telephone_number": "718-382-0045",
            "fax_number": "718-859-7157"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DROR",
        "first_name": "SOPHIA",
        "middle_name": "A",
        "credential": "LBA, LMHC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-08-07",
        "last_updated": "2023-04-12",
        "certification_date": "2023-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "NY",
            "license": "00234201",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SOPHIA",
            "last_name": "BAILEY",
            "middle_name": "ARIELLA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.