Jahleh Mohammadi St George, LMHC, RPT, CCPT

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Practice address

1237 Dutch Hill Rd
Tully, NY 13159-3057

Phone

(315) 289-2504

NPI assigned

Feb 5, 2015

Last updated

Aug 19, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Jahleh Mohammadi Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Jul 26, 2024 through Jul 26, 2028

Medicare enrollment (NPD)

Not enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Sanctuary Mental Health Counseling Services, PLLC

  • Mental Health Counselor
  • Syracuse, NY
  • NPI 1205541869
  NPD

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

{
    "created_epoch": "1423094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724025600000",
    "number": "1093106528",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1237 DUTCH HILL RD",
            "city": "TULLY",
            "state": "NY",
            "postal_code": "131593057",
            "telephone_number": "315-289-2504"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1237 DUTCH HILL RD",
            "city": "TULLY",
            "state": "NY",
            "postal_code": "131593057",
            "telephone_number": "315-289-2504"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ST GEORGE",
        "first_name": "JAHLEH",
        "middle_name": "MOHAMMADI",
        "name_prefix": "Mrs.",
        "credential": "LMHC, RPT, CCPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-02-05",
        "last_updated": "2024-08-19",
        "certification_date": "2024-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JAHLEH",
            "last_name": "MOHAMMADI",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Charles Nicholas Pirro, NP
• Colin Francis Rybak, RPH
• Michael Richard Saccone Jr., PT
• Matthew Robert Scheuer
• Darcy Shirtz, LPN
• Gregory Scott Steencken, MD
• Christine Ann Stewart, RN
• Susan S Thomas, LCSW
• Town of Tully
• Tully Central School District

• Mental Health Counselor in Tully, NY
• Providers in Tully, NY by specialty
• Mental Health Counselor in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.