Individual provider Active NPI

Amy Desimon, LMHC

  • Mental Health Counselor
  • Brooklyn, NY
National Provider Identifier
1114511771
Registry record updated Feb 24, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
011015-01 Issued in NY
Practice address
293 Hawthorne St Apt 6D
Brooklyn, NY 11225-6145
Phone
(585) 314-0821
NPI assigned
Feb 24, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 24, 2021

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 011015-01 NY Primary

Addresses

Primary practice location

293 Hawthorne St Apt 6D
Brooklyn, NY 11225-6145

Mailing address

293 Hawthorne St Apt 6D
Brooklyn, NY 11225-6145
Phone (585) 314-0821

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
011015-01NYMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1614124800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614124800000",
    "number": "1114511771",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "293 HAWTHORNE ST APT 6D",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112256145",
            "telephone_number": "585-314-0821"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "293 HAWTHORNE ST APT 6D",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112256145",
            "telephone_number": "585-314-0821"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DESIMON",
        "first_name": "AMY",
        "credential": "LMHC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-02-24",
        "last_updated": "2021-02-24",
        "certification_date": "2021-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NY",
            "license": "011015-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2021; 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.