Active NPI
Guillermo Calleja, L.M.H.C.
- Counselor
- Great Neck, NY
National Provider Identifier
1154835502
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- License
- 003916
- Practice address
- 11 Grace Ave Ste 204
Great Neck, NY 11021-2417 - Phone
- (917) 680-3882
- NPI assigned
- Nov 21, 2017
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 003916 | NY | |
| Counselor | 101Y00000X | 003916 | NY | Primary |
Addresses
Primary practice location
11 Grace Ave Ste 204
Great Neck, NY 11021-2417
Mailing address
11 Grace Avenue
Suite 204
Great Neck, NY 11021
Phone (917) 680-3882
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 003916 | NY | MD | Certified Respiratory Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1511222400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1511222400000",
"number": "1154835502",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11 GRACE AVENUE",
"address_2": "SUITE 204",
"city": "GREAT NECK",
"state": "NY",
"postal_code": "11021",
"telephone_number": "917-680-3882"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11 GRACE AVE STE 204",
"city": "GREAT NECK",
"state": "NY",
"postal_code": "110212417",
"telephone_number": "917-680-3882"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CALLEJA",
"first_name": "GUILLERMO",
"name_prefix": "Mr.",
"credential": "L.M.H.C.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-11-21",
"last_updated": "2017-11-21",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "NY",
"license": "003916",
"primary": false
},
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "NY",
"license": "003916",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Great Neck, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.