Jillian Lauren Decoursey, LMHC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

005490-1 Issued in NY

Practice address

7001 Metropolitan Ave
Middle Village, NY 11379

Phone

(718) 440-9637

NPI assigned

Mar 25, 2014

Last updated

Mar 25, 2014By 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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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.

• Create Your Balance Mental Health Counseling

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Little Neck, NY
  • NPI 1073274627
  NPD Authorized official

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

{
    "created_epoch": "1395705600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1395705600000",
    "number": "1093132391",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22405 KINGSBURY AVE",
            "address_2": "A",
            "city": "OAKLAND GARDENS",
            "state": "NY",
            "postal_code": "113643626"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7001 METROPOLITAN AVE",
            "city": "MIDDLE VILLAGE",
            "state": "NY",
            "postal_code": "11379",
            "telephone_number": "718-440-9637"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DECOURSEY",
        "first_name": "JILLIAN",
        "middle_name": "LAUREN",
        "credential": "LMHC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-03-25",
        "last_updated": "2014-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NY",
            "license": "005490-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Mental Health Counselor in Middle Village, NY
• Providers in Middle Village, 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 Mar 25, 2014; 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.