Kimberly Anne Cerqueira, MS, MHC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

P13797 Issued in NY

Practice address

506 Stewart Ave
Garden City, NY 11530-4706

Phone

(516) 705-3400

NPI assigned

Oct 22, 2018

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1540166400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1540166400000",
    "number": "1154897700",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "230 ATLANTIC AVE APT 4R",
            "city": "LYNBROOK",
            "state": "NY",
            "postal_code": "115633541",
            "telephone_number": "631-790-5002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "506 STEWART AVE",
            "city": "GARDEN CITY",
            "state": "NY",
            "postal_code": "115304706",
            "telephone_number": "516-705-3400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CERQUEIRA",
        "first_name": "KIMBERLY",
        "middle_name": "ANNE",
        "credential": "MS, MHC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-10-22",
        "last_updated": "2018-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": "NY",
            "license": "P13797",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Mental Health Counselor in Garden City, NY
• Providers in Garden City, NY by specialty
• Mental Health Counselor in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2018; 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.