Active NPI
Susanna Kitson Willingham, MPS,ATR-BC, NCPSYA
- Mental Health Counselor
- Nyack, NY
National Provider Identifier
1215080155
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- LMHC2939
- Practice address
- 50 Piermont Ave
2D
Nyack, NY 10960-3841 - Phone
- (845) 358-0722
- NPI assigned
- Jan 22, 2007
- Last updated
- Jul 8, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | LMHC2939 | NY | Primary |
| Mental Health Counselor | 101YM0800X | LPSYA412 | NY | |
| Mental Health Counselor | 101YM0800X | LCAT702 | NY | |
| Mental Health Counselor | 101YM0800X | LPC234300 | NY |
Addresses
Primary practice location
50 Piermont Ave
2D
Nyack, NY 10960-3841
Mailing address
50 Piermont Ave.
2D
Nyack, NY 10960-3861
Phone (845) 358-0722
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
| License | State | Type | Specialty |
|---|---|---|---|
| LCAT702 | NY | MD | Mental Health Counselor |
| LMHC2939 | NY | MD | Mental Health Counselor |
| LPC234300 | NY | MD | Mental Health Counselor |
| LPSYA412 | NY | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1169424000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1215080155",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "50 PIERMONT AVE.",
"address_2": "2D",
"city": "NYACK",
"state": "NY",
"postal_code": "109603861",
"telephone_number": "845-358-0722"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "50 PIERMONT AVE",
"address_2": "2D",
"city": "NYACK",
"state": "NY",
"postal_code": "109603841",
"telephone_number": "845-358-0722"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILLINGHAM",
"first_name": "SUSANNA",
"middle_name": "KITSON",
"credential": "MPS,ATR-BC, NCPSYA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-01-22",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "NY",
"license": "LMHC2939",
"primary": true
},
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "NY",
"license": "LPSYA412",
"primary": false
},
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "NY",
"license": "LCAT702",
"primary": false
},
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "NY",
"license": "LPC234300",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Nyack, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.