Active NPI
Michael Bordes, LMHC
- Mental Health Counselor
- Smithtown, NY
National Provider Identifier
1225468978
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- P82084
- Practice address
- 11 Route 111
Smithtown, NY 11787-3739 - Phone
- (631) 920-8300
- NPI assigned
- Nov 16, 2013
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | P82084 | NY | Primary |
Addresses
Primary practice location
11 Route 111
Smithtown, NY 11787-3739
Mailing address
11 Route 111
Smithtown, NY 11787-3739
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 |
|---|---|---|---|
| P82084 | NY | MD | Mental Health Counselor |
Networks
- Healthfirst Medicare Network H1722
- Healthfirst Medicare Network H9678
- Healthfirst Medicare Network H5989
- Healthfirst Medicare Network H3359
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1384560000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1384560000000",
"number": "1225468978",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11 ROUTE 111",
"city": "SMITHTOWN",
"state": "NY",
"postal_code": "117873739"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11 ROUTE 111",
"city": "SMITHTOWN",
"state": "NY",
"postal_code": "117873739",
"telephone_number": "631-920-8300"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BORDES",
"first_name": "MICHAEL",
"name_prefix": "Mr.",
"credential": "LMHC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2013-11-16",
"last_updated": "2013-11-16",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "NY",
"license": "P82084",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Smithtown, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 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.