Individual provider Active NPI

Esther Williams Ekanem, LMHC, CASAC, NCC

  • Mental Health Counselor
  • Medford, NY
National Provider Identifier
1215405980
Registry record updated Jul 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
010042 Issued in NY
Practice address
312 Expressway Dr S
Medford, NY 11763-2555
Phone
(631) 758-0474
NPI assigned
Nov 10, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 5, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 34658 NY
Mental Health Counselor 101YM0800X 010042 NY Primary

Addresses

Primary practice location

312 Expressway Dr S
Medford, NY 11763-2555

Mailing address

1301 Waverly Ave
Farmingville, NY 11738-1350
Phone (631) 213-1179

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
I20240224000263 NY Practitioner - Mental Health Counselor 3678918141 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Senior Care Therapy LCSW of New York PLLCGroup PAC ID 7113269010, 63 clinicians

Practice addresses (Care Compare)

14415 68TH Rd
Flushing, NY 11367-1330
Phone (973) 264-0023

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
34658NYMDAddiction (Substance Use Disorder) Counselor
010042NYMDPediatric Occupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Senior Care Therapy LCSW of New York PLLC Mental Health CurrentSince Feb 1, 2024 Accepting new patients
Concern for Independent Living, Inc. PastSince Apr 6, 2021 Accepting new patients

Locations

2719 Hollywood Blvd
Hollywood, FL 33020
Phone (954) 354-2555

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1541808000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688515200000",
    "number": "1215405980",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1301 WAVERLY AVE",
            "city": "FARMINGVILLE",
            "state": "NY",
            "postal_code": "117381350",
            "telephone_number": "631-213-1179"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "312 EXPRESSWAY DR S",
            "city": "MEDFORD",
            "state": "NY",
            "postal_code": "117632555",
            "telephone_number": "631-758-0474"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EKANEM",
        "first_name": "ESTHER",
        "middle_name": "WILLIAMS",
        "credential": "LMHC, CASAC, NCC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-11-10",
        "last_updated": "2023-07-05",
        "certification_date": "2023-07-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NY",
            "license": "34658",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NY",
            "license": "010042",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Medford, NY

Sources for this page

Verify at the official NPI Registry.