Individual provider Active NPI

Rose Regine Fenelon, M.S

  • Counselor
  • Dix Hills, NY
National Provider Identifier
1083059489
Registry record updated Apr 30, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
License
904B Issued in NY
Practice address
3 Croydon CT
Dix Hills, NY 11746-6143
Phone
(516) 280-0078
NPI assigned
Apr 30, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 30, 2013

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X 904B NY Primary

Addresses

Primary practice location

3 Croydon CT
Dix Hills, NY 11746-6143

Mailing address

3 Croydon CT
Dix Hills, NY 11746-6143
Phone (516) 280-0078

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
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
904BNYMDCounselor

Practice roles

OrganizationSpecialtyStatusNew patients
Little Treasures LLP Past 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": "1367280000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1367280000000",
    "number": "1083059489",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 CROYDON CT",
            "city": "DIX HILLS",
            "state": "NY",
            "postal_code": "117466143",
            "telephone_number": "516-280-0078"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 CROYDON CT",
            "city": "DIX HILLS",
            "state": "NY",
            "postal_code": "117466143",
            "telephone_number": "516-280-0078"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FENELON",
        "first_name": "ROSE",
        "middle_name": "REGINE",
        "name_prefix": "Ms.",
        "credential": "M.S",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-04-30",
        "last_updated": "2013-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "NY",
            "license": "904B",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dix Hills, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2013; 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.