Active NPI
Evelyn Cabral, CASAC
- Addiction (Substance Use Disorder) Counselor
- Selden, NY
National Provider Identifier
1053735902
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- License
- 12134
- Practice address
- 62 Hawthorne St
Selden, NY 11784-1336 - Phone
- (631) 830-1472
- NPI assigned
- Feb 13, 2014
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 12134 | NY | Primary |
Addresses
Primary practice location
62 Hawthorne St
Selden, NY 11784-1336
Mailing address
62 Hawthorne St
Selden, NY 11784-1336
Phone (631) 830-1472
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 12134 | Other | NY | CASAC |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 12134 | NY | MD | Addiction (Substance Use Disorder) Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1392249600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1392249600000",
"number": "1053735902",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "62 HAWTHORNE ST",
"city": "SELDEN",
"state": "NY",
"postal_code": "117841336",
"telephone_number": "631-830-1472"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "62 HAWTHORNE ST",
"city": "SELDEN",
"state": "NY",
"postal_code": "117841336",
"telephone_number": "631-830-1472"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CABRAL",
"first_name": "EVELYN",
"credential": "CASAC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2014-02-13",
"last_updated": "2014-02-13",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "NY",
"license": "12134",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CASAC",
"identifier": "12134",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Selden, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 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.