Individual provider Active NPI

Ardita Avdiu, LMHC

  • Mental Health Counselor
  • Staten Island, NY
National Provider Identifier
1184489452
Registry record updated Feb 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
01432001 Issued in NY
Practice address
4490 Hylan Blvd
Staten Island, NY 10312-6425
Phone
(718) 673-1714
NPI assigned
Feb 15, 2024
Last updated
Feb 15, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 15, 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 01432001 NY Primary

Addresses

Primary practice location

4490 Hylan Blvd
Staten Island, NY 10312-6425

Mailing address

4490 Hylan Blvd
Staten Island, NY 10312-6425
Phone (718) 673-1714

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
I20250226001842 NY Practitioner - Mental Health Counselor 0143740720 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2022
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services
Group practices
Osier Health PCGroup PAC ID 6507229317, 12 clinicians

Practice addresses (Care Compare)

169 Madison Ave
New York, NY 10016-5101
Phone (646) 814-1530

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
01432001NYMDMental Health Counselor
014320NYMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Osier Health PC Mental Health CurrentSince Dec 23, 2024 Accepting new patients
Fort Health Medical Group PA Past Accepting new patients
Willow Health, Inc Past Accepting new patients

Locations

169 Madison Ave
#15906
New York, NY 10016
Phone (646) 814-1530

169 Madison Ave
Ste 15906
New York, NY 10016

Interoperability endpoints

  • Direct secure messaging: ardita.avdiu@549960591081476.direct.elationemr.com

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": "1707955200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707955200000",
    "number": "1184489452",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4490 HYLAN BLVD",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103126425",
            "telephone_number": "718-673-1714"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4490 HYLAN BLVD",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103126425",
            "telephone_number": "718-673-1714"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AVDIU",
        "first_name": "ARDITA",
        "credential": "LMHC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-02-15",
        "last_updated": "2024-02-15",
        "certification_date": "2024-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NY",
            "license": "01432001",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Staten Island, NY

Sources for this page

Verify at the official NPI Registry.