Individual provider Active NPI

Carly Gemelle, CASAC-T

  • Addiction (Substance Use Disorder) Counselor
  • New York, NY
National Provider Identifier
1174785877
Registry record updated Jun 25, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
TBA Issued in NY
Practice address
8 E 3Rd St
New York, NY 10003-8908
Phone
(212) 763-0596
NPI assigned
Jun 25, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 25, 2008

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X TBA NY
Addiction (Substance Use Disorder) Counselor 101YA0400X TBA NY Primary
Case Manager/Care Coordinator 171M00000X TBA NY

Addresses

Primary practice location

8 E 3Rd St
New York, NY 10003-8908

Mailing address

186 Meserole St
Apt 6
Brooklyn, NY 11206-2136
Phone (917) 686-9878

Other identifiers 1

IdentifierTypeStateIssuer
TBAOtherNYCASAC-T

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

LicenseStateTypeSpecialty
TBANYMDAddiction (Substance Use Disorder) Counselor

NPI Registry JSON

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

{
    "created_epoch": "1214352000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1214352000000",
    "number": "1174785877",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "186 MESEROLE ST",
            "address_2": "APT 6",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112062136",
            "telephone_number": "917-686-9878"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8 E 3RD ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100038908",
            "telephone_number": "212-763-0596"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GEMELLE",
        "first_name": "CARLY",
        "credential": "CASAC-T",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-06-25",
        "last_updated": "2008-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "NY",
            "license": "TBA",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NY",
            "license": "TBA",
            "primary": true
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "NY",
            "license": "TBA",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CASAC-T",
            "identifier": "TBA",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2008; 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.