Individual provider Active NPI

Christopher Juzumas, LMHC

  • Mental Health Counselor
  • East Islip, NY
National Provider Identifier
1205654852
Registry record updated Oct 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
107 W Main St
East Islip, NY 11730-2337
Phone
(631) 666-1615
NPI assigned
Oct 2, 2024
Last updated
Oct 2, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 2, 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

107 W Main St
East Islip, NY 11730-2337

Mailing address

107 W Main St
East Islip, NY 11730-2337
Phone (631) 666-1615

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
I20241017000816 NY Practitioner - Mental Health Counselor 3870025604 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
015072NYMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Sunrise Counseling Center,LTD CurrentSince Oct 11, 2024 Accepting new patients

Locations

107 W Main St
East Islip, NY 11730
Phone (631) 666-1615

Organizations & group practices 1

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": "1727827200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727827200000",
    "number": "1205654852",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "107 W MAIN ST",
            "city": "EAST ISLIP",
            "state": "NY",
            "postal_code": "117302337",
            "telephone_number": "631-666-1615"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 W MAIN ST",
            "city": "EAST ISLIP",
            "state": "NY",
            "postal_code": "117302337",
            "telephone_number": "631-666-1615"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JUZUMAS",
        "first_name": "CHRISTOPHER",
        "credential": "LMHC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-10-02",
        "last_updated": "2024-10-02",
        "certification_date": "2024-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in East Islip, NY

Sources for this page

Verify at the official NPI Registry.