Individual provider Active NPI

Dana Valdemira, PHD., LMHC

  • Mental Health Counselor
  • Smithtown, NY
National Provider Identifier
1124410436
Registry record updated Jul 12, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
006695 Issued in NY
Practice address
267 E Main St Ste B22
Smithtown, NY 11787-2851
Phone
(516) 380-3453
NPI assigned
Feb 23, 2015
Last updated
Jul 12, 2020By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 12, 2020

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 006695 NY Primary

Addresses

Primary practice location

267 E Main St Ste B22
Smithtown, NY 11787-2851

Mailing address

45 Cleremont Ave
Saint James, NY 11780-1708
Phone (516) 380-3453

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
Credentials
Doctor of Philosophy

Practice roles

OrganizationSpecialtyStatusNew patients
Balanced Living Mental Health Counseling PLLC Mental Health CurrentSince Oct 13, 2024 Accepting new patients

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": "1424649600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1594512000000",
    "number": "1124410436",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "45 CLEREMONT AVE",
            "city": "SAINT JAMES",
            "state": "NY",
            "postal_code": "117801708",
            "telephone_number": "516-380-3453"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "267 E MAIN ST STE B22",
            "city": "SMITHTOWN",
            "state": "NY",
            "postal_code": "117872851",
            "telephone_number": "516-380-3453"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VALDEMIRA",
        "first_name": "DANA",
        "name_prefix": "Dr.",
        "credential": "PHD., LMHC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-02-23",
        "last_updated": "2020-07-12",
        "certification_date": "2020-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NY",
            "license": "006695",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Smithtown, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2020; 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.