Individual provider Active NPI

Stephanie Rathje, LMHC, LPC, CASAC-T

  • Mental Health Counselor
  • Sayville, NY
National Provider Identifier
1063159721
Registry record updated Mar 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
013204 Issued in NY
Practice address
93 Broadway Ave
Sayville, NY 11782-1618
Phone
(631) 388-2420
NPI assigned
May 15, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 28, 2025

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 013204 NY Primary

Addresses

Primary practice location

93 Broadway Ave
Sayville, NY 11782-1618

Mailing address

93 Broadway Ave
Sayville, NY 11782-1618
Phone (631) 388-2420

Other practice location 1

2B Roe Ave
Port Jefferson Station, NY 11776-4300
Phone (631) 388-2420

Other practice location 2

1129 Bay Shore Ave
Bay Shore, NY 11706-1938
Phone (631) 388-2420

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
013204NYMDClinical Child & Adolescent Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Iolite Mental Health Counseling, PLLC Mental Health CurrentSince Sep 1, 2024 Accepting new patients

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": "1652572800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743120000000",
    "number": "1063159721",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "93 BROADWAY AVE",
            "city": "SAYVILLE",
            "state": "NY",
            "postal_code": "117821618",
            "telephone_number": "631-388-2420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "93 BROADWAY AVE",
            "city": "SAYVILLE",
            "state": "NY",
            "postal_code": "117821618",
            "telephone_number": "631-388-2420"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2B Roe Ave",
            "address_purpose": "LOCATION",
            "city": "Port Jefferson Station",
            "state": "NY",
            "postal_code": "117764300",
            "country_code": "US",
            "telephone_number": "631-388-2420",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1129 Bay Shore Ave",
            "address_purpose": "LOCATION",
            "city": "Bay Shore",
            "state": "NY",
            "postal_code": "117061938",
            "country_code": "US",
            "telephone_number": "631-388-2420",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RATHJE",
        "first_name": "STEPHANIE",
        "credential": "LMHC, LPC, CASAC-T",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-05-15",
        "last_updated": "2025-03-28",
        "certification_date": "2025-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NY",
            "license": "013204",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sayville, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2025; 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.