Anthony Gaudioso, LMHC, NCC, PHD

Individual provider Active NPI Mental Health Counselor · Stone Ridge, NY

NPI 1083684096 · NPPES record last updated Aug 2, 2022

Key facts

NPI
1083684096
Entity type
Individual (NPI type 1)
Primary specialty
Mental Health Counselor 101YM0800X
License
000464 (NY)
Practice address
695 Buck Rd
Stone Ridge, NY 12484-5500
Phone
(212) 729-1450
NPI assigned
Jan 23, 2006
Sex
Male
Sole proprietor
Yes

Organizations & group practices 2

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.

Medicare Care Compare profile

Specialty
Mental Health Counselor
Education
Other, 2004
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

695 Buck Rd
Stone Ridge, NY 12484-5500
Phone (917) 470-9224

Medicare participation

Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20240126002890 NY Practitioner - Mental Health Counselor 5799138699 Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
000464NYMDBehavioral Analyst

Practice roles

OrganizationSpecialtyStatusNew patients
Anthony Gaudioso, PH.D, Licensed Mental Health Counselor, P.C. Mental Health Current
since Jan 1, 2024
Accepting new patients
Anthony Gaudioso, PHD, LMHC , PC. Mental Health Current
since Jul 1, 2021
Accepting new patients

Locations

79 Saint James St
#2
Kingston, NY 12401
Phone (212) 729-1450

1133 Broadway
Ste 1508
New York, NY 10010
Phone (646) 416-0482

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 000464 NY Yes

Addresses

Primary practice location

695 Buck Rd
Stone Ridge, NY 12484-5500

Mailing address

695 Buck Rd
Stone Ridge, NY 12484-5500
Phone (212) 729-1450

Other practice location 1

79 Saint James St Fl 2
Kingston, NY 12401-4513
Phone (212) 729-1450

Other names

  • Dr. Tony Gaudioso Other name

Electronic endpoints

TypeEndpointUseAffiliation
CONNECT URL Drgaudioso@mac.com Health Information Exchange (HIE)

Other providers in Stone Ridge, NY

All providers in Stone Ridge, NY · Mental Health Counselor in New York

Sources for this page

Verify at the official NPI Registry.