Individual provider Active NPI

Katherine Rodriguez, MS, MHC-LP

  • Mental Health Counselor
  • New York, NY
National Provider Identifier
1063180198
Registry record updated Sep 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
P111544 Issued in NY
Practice address
109 E 115TH St
New York, NY 10029-1186
Phone
(347) 306-8537
NPI assigned
Sep 2, 2021
Last updated
Sep 2, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 2, 2021

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 P111544 NY Primary

Addresses

Primary practice location

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

Mailing address

590 6TH Ave
New York, NY 10011-2022
Phone (212) 633-9300

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2019
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

10470 Queens Blvd
Suite 200
Forest Hills, NY 11375-3635

23716 Fairbury Ave
Bellerose, NY 11426-1140

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
P111544NYMDMental Health Counselor

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/CFJAED/Endpoint/CFJAED

NPI Registry JSON

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

{
    "created_epoch": "1630540800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630540800000",
    "number": "1063180198",
    "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",
            "telephone_number": "212-633-9300"
        },
        {
            "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": "347-306-8537"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGUEZ",
        "first_name": "KATHERINE",
        "credential": "MS, MHC-LP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-09-02",
        "last_updated": "2021-09-02",
        "certification_date": "2021-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NY",
            "license": "P111544",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.