Active NPI
Wendy Elizabeth Nelson, MENTAL HEALTH THERAP
- Marriage & Family Therapist
- New York, NY
National Provider Identifier
1083822258
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 000401
- Practice address
- 124 W 79TH St
Suite 1B
New York, NY 10024-6470 - Phone
- (212) 721-0336
- NPI assigned
- May 19, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 002420 | NY | |
| Marriage & Family Therapist | 106H00000X | 000401 | NY | Primary |
Addresses
Primary practice location
124 W 79TH St
Suite 1B
New York, NY 10024-6470
Mailing address
124 W 79TH St
Suite 1B
New York, NY 10024-6470
Phone (212) 721-0336
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 002420 | Other | NY | MENTAL HEALTH THERAPIST |
| 000401 | Other | NY | MARRIAGE AND FAMILY THERA |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 000401 | NY | MD | Psychoanalyst |
| 002420 | NY | MD | Acupuncturist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179532800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1315526400000",
"number": "1083822258",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "124 W 79TH ST",
"address_2": "SUITE 1B",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100246470",
"telephone_number": "212-721-0336"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "124 W 79TH ST",
"address_2": "SUITE 1B",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100246470",
"telephone_number": "212-721-0336"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NELSON",
"first_name": "WENDY",
"middle_name": "ELIZABETH",
"name_prefix": "Ms.",
"credential": "MENTAL HEALTH THERAP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-05-19",
"last_updated": "2011-09-09",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "NY",
"license": "002420",
"primary": false
},
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "NY",
"license": "000401",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MENTAL HEALTH THERAPIST",
"identifier": "002420",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MARRIAGE AND FAMILY THERA",
"identifier": "000401",
"state": "NY"
}
],
"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 9, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.