Active NPI
Katherine Rodriguez, MS, MHC-LP
- Mental Health Counselor
- New York, NY
National Provider Identifier
1063180198
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- P111544
- Practice address
- 109 E 115TH St
New York, NY 10029-1186 - Phone
- (347) 306-8537
- NPI assigned
- Sep 2, 2021
- Last updated
- Sep 2, 2021
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| 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
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
| License | State | Type | Specialty |
|---|---|---|---|
| P111544 | NY | MD | Mental Health Counselor |
Interoperability endpoints
- 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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.