Individual provider Active NPI

Andre Marmorstein

  • Mental Health Counselor
  • Brooklyn, NY
National Provider Identifier
1114388139
Registry record updated Mar 18, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
096337
Practice address
425 Kings Hwy
Brooklyn, NY 11223-1629
Phone
(718) 787-1100
NPI assigned
Mar 18, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 18, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 096337 Primary

Addresses

Primary practice location

425 Kings Hwy
Brooklyn, NY 11223-1629

Mailing address

425 Kings Hwy
Brooklyn, NY 11223-1629
Phone (718) 787-1100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241212002965 NY Practitioner - Clinical Social Worker 3779019872 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Pesach Tikvah Hope Development Inc Mental Health CurrentSince Sep 21, 2024 Accepting new patients
Pesach Tikvah Hope Development Inc Mental Health Current Accepting new patients
SBH Community Service Network, Inc. PastSince Aug 22, 2011 Accepting new patients
Sephardic Bikur Holim Past Accepting new patients

Locations

926 Bedford Ave
Brooklyn, NY 11205
Phone (718) 865-6900

5309 18th Ave
Brooklyn, NY 11204
Phone (718) 705-5190

365 Willoughby Ave
Ste 400
Brooklyn, NY 11205

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1458259200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1458259200000",
    "number": "1114388139",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "425 KINGS HWY",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112231629",
            "telephone_number": "718-787-1100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "425 KINGS HWY",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112231629",
            "telephone_number": "718-787-1100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARMORSTEIN",
        "first_name": "ANDRE",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-03-18",
        "last_updated": "2016-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": "096337",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.