Individual provider Active NPI

Marilyn Ditullio, LMHC

  • Mental Health Counselor
  • Katonah, NY
National Provider Identifier
1184059438
Registry record updated Mar 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
95 Route 100
Katonah, NY 10536-3319
Phone
(914) 263-9933
NPI assigned
Sep 5, 2013
Last updated
Mar 17, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 17, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X NU Primary

Addresses

Primary practice location

95 Route 100
Katonah, NY 10536-3319

Mailing address

PO Box 135
Katonah, NY 10536-0135
Phone (914) 263-9933

Other practice location 1

24 Smith Ave
Mount Kisco, NY 10549-2814
Phone (914) 666-6740 ext. 1905

Other names 1

  • Marilyn Sussmann Ditullio Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240306001675 NY Practitioner - Mental Health Counselor 0840636494 Practice locations: Katonah, NY

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

95 Route 100
Katonah, NY 10536-3319
Phone (914) 263-9933

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Lexington Center for Recovery, Inc. CurrentSince Nov 1, 2019 Accepting new patients
Bridgewell, Inc Past Accepting new patients
Bridgewell Counseling Mental Health Past Accepting new patients

Locations

24 Smith Ave
Mount Kisco, NY 10549
Phone (914) 666-0191

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1378339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710633600000",
    "number": "1184059438",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 135",
            "city": "KATONAH",
            "state": "NY",
            "postal_code": "105360135",
            "telephone_number": "914-263-9933",
            "fax_number": "914-471-9081"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "95 ROUTE 100",
            "city": "KATONAH",
            "state": "NY",
            "postal_code": "105363319",
            "telephone_number": "914-263-9933"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "24 Smith Ave",
            "address_purpose": "LOCATION",
            "city": "Mount Kisco",
            "state": "NY",
            "postal_code": "105492814",
            "country_code": "US",
            "telephone_number": "914-666-6740 x1905",
            "fax_number": "914-666-8596",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DITULLIO",
        "first_name": "MARILYN",
        "credential": "LMHC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-09-05",
        "last_updated": "2024-03-17",
        "certification_date": "2024-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARILYN",
            "last_name": "SUSSMANN DITULLIO",
            "credential": "LMHC",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Katonah, NY

Sources for this page

Verify at the official NPI Registry.