Active NPI
Kelly Gleeson
- Mental Health Counselor
- Hicksville, NY
National Provider Identifier
1134052491
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- Practice address
- 120 Bethpage Rd Ste 101
Hicksville, NY 11801-1515 - Phone
- (631) 696-4357
- NPI assigned
- Jun 5, 2026
- Sex
- Unspecified or another gender identity
- 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 |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | Primary |
Addresses
Primary practice location
120 Bethpage Rd Ste 101
Hicksville, NY 11801-1515
Mailing address
1377 Motor Pkwy Ste 102
Islandia, NY 11749-5249
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1780617600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1780617600000",
"number": "1134052491",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1377 MOTOR PKWY STE 102",
"city": "ISLANDIA",
"state": "NY",
"postal_code": "117495249"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "120 BETHPAGE RD STE 101",
"city": "HICKSVILLE",
"state": "NY",
"postal_code": "118011515",
"telephone_number": "631-696-4357"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GLEESON",
"first_name": "KELLY",
"sole_proprietor": "NO",
"sex": "X",
"enumeration_date": "2026-06-05",
"last_updated": "2026-06-05",
"certification_date": "2026-06-05",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Hicksville, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.