Active NPI
Sequoyah Wharton, ED.D.
- Mental Health Counselor
- Coram, NY
National Provider Identifier
1174129530
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- Practice address
- 1970 Route 112 Ste 6
Coram, NY 11727-2300 - Phone
- (631) 333-0096
- NPI assigned
- Dec 9, 2020
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Research Study Specialist | 1744R1102X | |||
| Research Clinic/Center | 261QR1100X | |||
| Mental Health Counselor | 101YM0800X | Primary |
Addresses
Primary practice location
1970 Route 112 Ste 6
Coram, NY 11727-2300
Mailing address
60 Marshall Dr
Selden, NY 11784-2312
Phone (631) 236-7274
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | support@beyondthebasicseducation.org | Health Information Exchange (HIE) |
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1607472000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1607472000000",
"number": "1174129530",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "60 MARSHALL DR",
"city": "SELDEN",
"state": "NY",
"postal_code": "117842312",
"telephone_number": "631-236-7274"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1970 ROUTE 112 STE 6",
"city": "CORAM",
"state": "NY",
"postal_code": "117272300",
"telephone_number": "631-333-0096"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WHARTON",
"first_name": "SEQUOYAH",
"name_prefix": "Dr.",
"credential": "ED.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2020-12-09",
"last_updated": "2020-12-09",
"certification_date": "2020-12-09",
"status": "A"
},
"taxonomies": [
{
"code": "1744R1102X",
"taxonomy_group": "",
"desc": "Specialist, Research Study",
"state": null,
"license": null,
"primary": false
},
{
"code": "261QR1100X",
"taxonomy_group": "",
"desc": "Clinic/Center, Research",
"state": null,
"license": null,
"primary": false
},
{
"code": "101YM0800X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Counselor, Mental Health",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "support@beyondthebasicseducation.org",
"affiliation": "N",
"endpointDescription": "Email",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "1970 Route 112 Ste 6",
"city": "Coram",
"state": "NY",
"country_code": "US",
"postal_code": "117272300",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Coram, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.