Katherine Ambrosino, LMHC

Key facts

NPI

1164844809

Entity type

Individual (NPI type 1)

Primary specialty

Mental Health Counselor 101YM0800X

License

005869 (NY)

Practice address

1600 Deer Park Ave
Deer Park, NY 11729-5208

Phone

(917) 723-9875

NPI assigned

Jan 15, 2014

Sex

Female

Sole proprietor

Yes

Medicare participation

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)

No

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jan 15, 2014.

{
    "created_epoch": "1389744000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1389744000000",
    "number": "1164844809",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "136 OAKLAND AVE",
            "city": "MILLER PLACE",
            "state": "NY",
            "postal_code": "117643116",
            "telephone_number": "917-723-9875"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 DEER PARK AVE",
            "city": "DEER PARK",
            "state": "NY",
            "postal_code": "117295208",
            "telephone_number": "917-723-9875"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AMBROSINO",
        "first_name": "KATHERINE",
        "credential": "LMHC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-01-15",
        "last_updated": "2014-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NY",
            "license": "005869",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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All providers in Deer Park, NY · Mental Health Counselor in New York