Individual provider Active NPI

Bernadette M Diangelo, LCSW

  • Mental Health Counselor
  • Baldwin, NY
National Provider Identifier
1144486291
Registry record updated Jul 29, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
R054194-1 Issued in NY
Practice address
2277 Grand Ave
Baldwin, NY 11510-3148
Phone
(516) 377-5400
NPI assigned
Jul 29, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 29, 2008

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 R054194-1 NY Primary

Addresses

Primary practice location

2277 Grand Ave
Baldwin, NY 11510-3148

Mailing address

1052 Archer PL
Baldwin, NY 11510-3604
Phone (516) 665-8548

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
R054194-1NYMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Southeast Nassau Guidance Center Past Accepting new patients
Southeast Nassau Guidance Center Inc. Past Accepting new patients

Organizations & group practices 2

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": "1217289600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1217289600000",
    "number": "1144486291",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1052 ARCHER PL",
            "city": "BALDWIN",
            "state": "NY",
            "postal_code": "115103604",
            "telephone_number": "516-665-8548"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2277 GRAND AVE",
            "city": "BALDWIN",
            "state": "NY",
            "postal_code": "115103148",
            "telephone_number": "516-377-5400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIANGELO",
        "first_name": "BERNADETTE",
        "middle_name": "M",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-07-29",
        "last_updated": "2008-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NY",
            "license": "R054194-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baldwin, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2008; 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.