Active NPI
Carmen Betancourt-Nedwick, LCSW
- Counselor
- Brentwood, NY
National Provider Identifier
1124161815
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- License
- 071027
- Practice address
- 452 Suffolk Ave
Brentwood, NY 11717-4207 - Phone
- (631) 436-6065
- NPI assigned
- Feb 14, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | 071027 | NY | Primary |
Addresses
Primary practice location
452 Suffolk Ave
Brentwood, NY 11717-4207
Mailing address
9 Lace LN
Central Islip, NY 11722-2017
Phone (631) 224-5330
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
| License | State | Type | Specialty |
|---|---|---|---|
| 071027 | NY | MD | Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Town of Islip | Past | Accepting new patients | |
| Outreach Development Corporation | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Addiction (Substance Use Disorder) Counselor
- Richmond Hill, NY
- NPI 1083717326
-
- Addiction (Substance Use Disorder) Counselor
- Brentwood, NY
- NPI 1215029004
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1171411200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1124161815",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9 LACE LN",
"city": "CENTRAL ISLIP",
"state": "NY",
"postal_code": "117222017",
"telephone_number": "631-224-5330"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "452 SUFFOLK AVE",
"city": "BRENTWOOD",
"state": "NY",
"postal_code": "117174207",
"telephone_number": "631-436-6065"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BETANCOURT-NEDWICK",
"first_name": "CARMEN",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-02-14",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "NY",
"license": "071027",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Brentwood, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.