Chanill Medina

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

37FI00255300 Issued in NJ

Practice address

121 Cedar LN Ste 102
Teaneck, NJ 07666-4457

Phone

(201) 357-9885

NPI assigned

Jan 7, 2021

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Generational Wellness Center

  • Marriage & Family Therapist
  • Teaneck, NJ
  • NPI 1740123264
  NPD Authorized official
• D & S Psychological Services LLC

  • Clinical Social Worker
  • Paramus, NJ
  • NPI 1063757060
  NPD (past)

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

{
    "created_epoch": "1609977600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1786579200000",
    "number": "1104414895",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "121 CEDAR LN STE 102",
            "city": "TEANECK",
            "state": "NJ",
            "postal_code": "076664457",
            "telephone_number": "201-357-9885"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "121 CEDAR LN STE 102",
            "city": "TEANECK",
            "state": "NJ",
            "postal_code": "076664457",
            "telephone_number": "201-357-9885"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEDINA",
        "first_name": "CHANILL",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-01-07",
        "last_updated": "2026-08-13",
        "certification_date": "2026-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "NJ",
            "license": "37FI00255300",
            "primary": true
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "NY",
            "license": "002774",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1230891",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Christopher McIntyre, CNIM
• Michael F McIntyre, CNIM
• Tara Anne McNally
• Roberta Nicole McNeill, M.D.
• Medical Imaging of Teaneck Inc.
• Esther Mehler, MA CCC/SLP
• Shalom Mehler, D.M.D.
• Deeksha Mehta, M.D.
• Meikle Mobile Medical Support Services
• Winston M Meikle Sr.

• Marriage & Family Therapist in Teaneck, NJ
• Providers in Teaneck, NJ by specialty
• Marriage & Family Therapist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2026; 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.