Selff Recovery Coaching

Primary specialty

Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X

Legal business name

SELFF RECOVERY COACHING

Practice address

2150 E Tremont Ave Apt 5G
Bronx, NY 10462-5732

Phone

(917) 383-5753

NPI assigned

Jul 6, 2022

Last updated

Jul 6, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Tylie Yolander Mitchell, LP-MHC,CASACNPI 1881131068

Title

Owner

Phone

(191) 738-3575

Specialties & licenses 2

Addresses

Other identifiers 3

Other names 2

• Selff Recovery Coaching Former legal business name
• Tylie Mitchell Former legal business name

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Tylie Y Mitchell

  • Mental Health Counselor
  • Bronx, NY
  • NPI 1881131068
  NPD Authorized official

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

{
    "created_epoch": "1657065600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1657065600000",
    "number": "1164155305",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2150 E TREMONT AVE APT 5G",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104625732",
            "telephone_number": "917-383-5753"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2150 E TREMONT AVE APT 5G",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104625732",
            "telephone_number": "917-383-5753"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SELFF RECOVERY COACHING",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-07-06",
        "last_updated": "2022-07-06",
        "certification_date": "2022-04-08",
        "status": "A",
        "authorized_official_last_name": "MITCHELL",
        "authorized_official_first_name": "TYLIE",
        "authorized_official_middle_name": "YOLANDER",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "191-738-3575",
        "authorized_official_credential": "LP-MHC,CASAC"
    },
    "taxonomies": [
        {
            "code": "103TP2701X",
            "taxonomy_group": "",
            "desc": "Psychologist, Group Psychotherapy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FEE FOR SERVICE",
            "identifier": "18102958-01",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "18102958-01",
            "identifier": "18102958-01",
            "state": "NM"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "18102958-01",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Selff Recovery Coaching",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "Tylie Mitchell",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Leslie Wilfred Seldin, DDS
• Selective Home Care Agency, Inc
• Warren Selekman, PH.D.
• Elizabeth Gabrielle Selesny, PA-C
• Self
• Melissa Selian
• Selig Eisenberg,M.D., PC.
• Sandra J Selikson, MD
• Samantha Sellers
• Yael Nina Selter, M.A. CCC-SLP TSSLD

• Substance Use Disorder Rehabilitation Clinic/Center in Bronx, NY
• Providers in Bronx, NY by specialty
• Substance Use Disorder Rehabilitation Clinic/Center in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 2022; 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.