Individual provider Active NPI

Amalia Nora Rudnik, M.A.

  • Mental Health Counselor
  • Brooklyn, NY
National Provider Identifier
1144744715
Registry record updated Dec 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
15 2ND Ave FL 3
Brooklyn, NY 11215-2711
Phone
(718) 514-6007
NPI assigned
Jul 26, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 27, 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

15 2ND Ave FL 3
Brooklyn, NY 11215-2711

Mailing address

15 2ND Ave FL 3
Brooklyn, NY 11215-2711
Phone (718) 514-6007

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
I20250207002887 NY Practitioner - Mental Health Counselor 7113457979 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

Practice roles

OrganizationSpecialtyStatusNew patients
Revcore Recovery Center of Manhattan, LLC CurrentSince Nov 11, 2024 Accepting new patients

Locations

15 2nd Ave
Fl 3
Brooklyn, NY 11215
Phone (718) 514-6007

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": "1501027200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703635200000",
    "number": "1144744715",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 2ND AVE FL 3",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112152711",
            "telephone_number": "718-514-6007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 2ND AVE FL 3",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112152711",
            "telephone_number": "718-514-6007"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUDNIK",
        "first_name": "AMALIA",
        "middle_name": "NORA",
        "name_prefix": "Miss",
        "credential": "M.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-07-26",
        "last_updated": "2023-12-27",
        "certification_date": "2023-12-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.