Active NPI
Kaitlyn Niewiarowicz
- Mental Health Counselor
- New York, NY
National Provider Identifier
1104584663
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 013625
- Practice address
- 109 W 27TH St Ste 5S
New York, NY 10001-0265 - Phone
- (833) 351-8255
- NPI assigned
- Dec 2, 2021
- Last updated
- Oct 31, 2024
- 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 | P110640 | NY | |
| Mental Health Counselor | 101YM0800X | 013625 | NY | Primary |
Addresses
Primary practice location
109 W 27TH St Ste 5S
New York, NY 10001-0265
Mailing address
PO Box 24449
New York, NY 10087-0589
Phone (833) 351-8255
Other practice location 1
275 North St
Harrison, NY 10528-1140
Phone (914) 967-6500
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| P110640 | NY | MD | Mental Health Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| MCCD Psychiatry Services PLLC | Current | Accepting new patients |
Locations
109 W 27th St
Rm 5S
New York, NY 10001
Phone (332) 230-4572
Organizations & group practices 1
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1638403200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1730332800000",
"number": "1104584663",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 24449",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100870589",
"telephone_number": "833-351-8255"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "109 W 27TH ST STE 5S",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100010265",
"telephone_number": "833-351-8255"
}
],
"practiceLocations": [
{
"address_1": "275 North St",
"address_purpose": "LOCATION",
"city": "Harrison",
"state": "NY",
"postal_code": "105281140",
"country_code": "US",
"telephone_number": "914-967-6500",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "NIEWIAROWICZ",
"first_name": "KAITLYN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-12-02",
"last_updated": "2024-10-31",
"certification_date": "2024-10-31",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "NY",
"license": "P110640",
"primary": false
},
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "NY",
"license": "013625",
"primary": true
}
],
"identifiers": [],
"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 Oct 31, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.