Individual provider Active NPI

Marellyn Lajara-Ottley, LMHC

  • Mental Health Counselor
  • Brooklyn, NY
National Provider Identifier
1134460595
Registry record updated Dec 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
102 Pilling Street
Brooklyn, NY 11207
Phone
(718) 602-1000
NPI assigned
Mar 11, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 6, 2023

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 Primary

Addresses

Primary practice location

102 Pilling Street
Brooklyn, NY 11207

Mailing address

102 Pilling Street
Brooklyn, NY 11207
Phone (646) 244-5832

Other names 1

  • Marellyn Lajara Former name

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: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Coordinated Behavioral Care Ipa Inc PastSince Dec 10, 2023 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1362960000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701820800000",
    "number": "1134460595",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "102 PILLING STREET",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "11207",
            "telephone_number": "646-244-5832"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 PILLING STREET",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "11207",
            "telephone_number": "718-602-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAJARA-OTTLEY",
        "first_name": "MARELLYN",
        "credential": "LMHC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-03-11",
        "last_updated": "2023-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARELLYN",
            "last_name": "LAJARA",
            "credential": "MHC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.