Individual provider Active NPI

Dylan Shayla Clay-Devlin

  • Mental Health Counselor
  • New York, NY
National Provider Identifier
1063019123
Registry record updated Sep 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
109 E 115TH St
New York, NY 10029-1186
Phone
(212) 633-9300
NPI assigned
Oct 1, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 5, 2023

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 Primary

Addresses

Primary practice location

109 E 115TH St
New York, NY 10029-1186

Mailing address

590 6TH Ave
New York, NY 10011-2022

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
I20251015000583 NY Practitioner - Mental Health Counselor 6406343268 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2021
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

590 Ave of the Americas
New York, NY 10011-2022

590 Ave of the Americas
FL 10
New York, NY 10011

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
New York Foundling CurrentSince Aug 1, 2025 Accepting new patients
The New York Foundling Hospital CurrentSince Aug 1, 2025 Accepting new patients

Locations

170 Brown Pl
Bronx, NY 10454
Phone (212) 206-7140

590 Avenue of the Americas
New York, NY 10011
Phone (646) 459-3401

Organizations & group practices 2

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": "1601510400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693872000000",
    "number": "1063019123",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "590 6TH AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100112022"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "109 E 115TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100291186",
            "telephone_number": "212-633-9300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLAY-DEVLIN",
        "first_name": "DYLAN",
        "middle_name": "SHAYLA",
        "name_prefix": "Ms.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-10-01",
        "last_updated": "2023-09-05",
        "certification_date": "2023-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.