Individual provider Active NPI

Cristiane De Medeiros Passarela

  • Mental Health Counselor
  • New York, NY
National Provider Identifier
1073126066
Registry record updated Aug 28, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
006864 Issued in NY
Practice address
55 W 39TH St RM 305
New York, NY 10018-3830
Phone
(917) 510-9200
NPI assigned
Aug 28, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 28, 2020

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 006864 NY Primary

Addresses

Primary practice location

55 W 39TH St RM 305
New York, NY 10018-3830

Mailing address

55 W 39TH St RM 305
New York, NY 10018-3830

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

NPI Registry JSON

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

{
    "created_epoch": "1598572800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1598572800000",
    "number": "1073126066",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 W 39TH ST RM 305",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100183830"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 W 39TH ST RM 305",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100183830",
            "telephone_number": "917-510-9200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DE MEDEIROS PASSARELA",
        "first_name": "CRISTIANE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-08-28",
        "last_updated": "2020-08-28",
        "certification_date": "2020-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NY",
            "license": "006864",
            "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 Aug 28, 2020; 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.