Individual provider Active NPI

Barbara Giannelli-O'Brien, LCSW

  • Mental Health Counselor
  • South Setauket, NY
National Provider Identifier
1144239484
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
R040503-1 Issued in NY
Practice address
3771 Nesconset Hwy Ste 208a
South Setauket, NY 11720-1154
Phone
(631) 751-9600
NPI assigned
Aug 5, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 R040503-1 NY Primary

Addresses

Primary practice location

3771 Nesconset Hwy Ste 208a
South Setauket, NY 11720-1154

Mailing address

3771 Nesconset Hwy Ste 208a
South Setauket, NY 11720-1154
Phone (631) 751-9600

Other identifiers 1

IdentifierTypeStateIssuer
21387OtherNVVYTRA VALUE OPTIONS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040506000054 NY Practitioner - Clinical Social Worker 5294723201 Practice locations: Centereach, NY

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
State University of New York at Stony Brook, School of Medicine, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

3771 Nesconset Hwy
Suite 208a
Centereach, NY 11720-1154
Phone (631) 751-1416

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
R040503-1NYMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1154736000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1144239484",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3771 NESCONSET HWY STE 208A",
            "city": "SOUTH SETAUKET",
            "state": "NY",
            "postal_code": "117201154",
            "telephone_number": "631-751-9600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3771 NESCONSET HWY STE 208A",
            "city": "SOUTH SETAUKET",
            "state": "NY",
            "postal_code": "117201154",
            "telephone_number": "631-751-9600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIANNELLI-O'BRIEN",
        "first_name": "BARBARA",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-05",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NY",
            "license": "R040503-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VYTRA VALUE OPTIONS",
            "identifier": "21387",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in South Setauket, NY

Sources for this page

Verify at the official NPI Registry.