Individual provider Active NPI

Carissa Ann Costello, LMHC

  • Mental Health Counselor
  • East Meadow, NY
National Provider Identifier
1205178167
Registry record updated May 8, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
005335-1 Issued in NY
Practice address
100 Carman Ave
East Meadow, NY 11554-1160
Phone
(516) 572-3953
NPI assigned
Mar 19, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 8, 2013

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 005335-1 NY Primary

Addresses

Primary practice location

100 Carman Ave
East Meadow, NY 11554-1160

Mailing address

100 Carman Ave
East Meadow, NY 11554-1160
Phone (516) 572-3953

Other names 1

  • Mrs. Carissa Ann Slokovitz Former name

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
005335-1NYMDPhysician Assistant

NPI Registry JSON

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

{
    "created_epoch": "1363651200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1367971200000",
    "number": "1205178167",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 CARMAN AVE",
            "city": "EAST MEADOW",
            "state": "NY",
            "postal_code": "115541160",
            "telephone_number": "516-572-3953"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 CARMAN AVE",
            "city": "EAST MEADOW",
            "state": "NY",
            "postal_code": "115541160",
            "telephone_number": "516-572-3953"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COSTELLO",
        "first_name": "CARISSA",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "LMHC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-03-19",
        "last_updated": "2013-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NY",
            "license": "005335-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CARISSA",
            "last_name": "SLOKOVITZ",
            "middle_name": "ANN",
            "prefix": "MRS.",
            "credential": "LMHC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in East Meadow, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2013; 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.