Andrew Kenneth Wakschal, LMHC

Primary specialty

CounselorTaxonomy code 101Y00000X

License

015235 Issued in NY

Practice address

153 New Dorp LN
Staten Island, NY 10306-3050

Phone

(929) 334-3521

NPI assigned

Sep 12, 2022

Last updated

Nov 7, 2024By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1662940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730937600000",
    "number": "1215658950",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "153 NEW DORP LN",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103063050",
            "telephone_number": "929-334-3521"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "153 NEW DORP LN",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103063050",
            "telephone_number": "929-334-3521"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAKSCHAL",
        "first_name": "ANDREW",
        "middle_name": "KENNETH",
        "name_prefix": "Mr.",
        "credential": "LMHC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-09-12",
        "last_updated": "2024-11-07",
        "certification_date": "2024-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "NY",
            "license": "015235",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "amanda.wood@peaceofmindmhcsi.com",
            "affiliation": "N",
            "endpointDescription": "Business Email of Clinical Supervisor",
            "address_1": "153 New Dorp Ln",
            "city": "Staten Island",
            "state": "NY",
            "country_code": "US",
            "postal_code": "103063050",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Candice Ashley Wagner, RN
• Debra Wagner
• Maung Tint Wai, MD
• George Wakeham
• Veronica Wakeman, LPN
• Stephen Jeffrey Wakschal, PHD
• Jillian Taylor Wald, PHARMD, RPH
• Joyce Wald
• Waldbaum Inc (Waldbaums Pharmacy)
• Waldbaum Inc (Waldbaums Pharmacy)

• Counselor in Staten Island, NY
• Providers in Staten Island, NY by specialty
• Counselor in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2024; 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.