Individual provider Active NPI

Karli Coverdale

  • Mental Health Counselor
  • Islandia, NY
National Provider Identifier
1124534177
Registry record updated May 4, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
1767 Veterans Hwy Ste 24
Islandia, NY 11749-1536
Phone
(631) 263-8307
NPI assigned
Dec 28, 2017
Sex
Female
Sole proprietor
Yes

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 and National Provider Directory roles.

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
00202NYMDBehavioral Analyst

Practice roles

OrganizationSpecialtyStatusNew patients
About Building Connections Mental Health Counseling Services Mental Health CurrentSince May 7, 2023 Accepting new patients

Locations

1767 Veterans Hwy
Ste 24
Islandia, NY 11749
Phone (631) 263-8307

Specialties & licenses 2

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Behavior AnalystGroup: 193400000X SINGLE SPECIALTY GROUP 103K00000X 00202 NY
Mental Health Counselor 101YM0800X Primary

Addresses

NPPES NPI Registry

Primary practice location

1767 Veterans Hwy Ste 24
Islandia, NY 11749-1536

Mailing address

1767 Veterans Hwy Ste 24
Islandia, NY 11749-1536

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on May 4, 2023.

{
    "created_epoch": "1514419200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683158400000",
    "number": "1124534177",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1767 VETERANS HWY STE 24",
            "city": "ISLANDIA",
            "state": "NY",
            "postal_code": "117491536"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1767 VETERANS HWY STE 24",
            "city": "ISLANDIA",
            "state": "NY",
            "postal_code": "117491536",
            "telephone_number": "631-263-8307"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COVERDALE",
        "first_name": "KARLI",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-12-28",
        "last_updated": "2023-05-04",
        "certification_date": "2023-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Behavior Analyst",
            "state": "NY",
            "license": "00202",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Islandia, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2023; 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.