Felicia Angela Jettoo

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

011746 Issued in NY

Practice address

11515 95TH Ave
South Richmond Hill, NY 11419-1239

Phone

(347) 997-2691

NPI assigned

Aug 6, 2022

Sex

Female

Sole proprietor

No

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

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

{
    "created_epoch": "1659744000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659744000000",
    "number": "1235866427",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11515 95TH AVE",
            "city": "SOUTH RICHMOND HILL",
            "state": "NY",
            "postal_code": "114191239",
            "telephone_number": "347-997-2691"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11515 95TH AVE",
            "city": "SOUTH RICHMOND HILL",
            "state": "NY",
            "postal_code": "114191239",
            "telephone_number": "347-997-2691"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JETTOO",
        "first_name": "FELICIA",
        "middle_name": "ANGELA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-08-06",
        "last_updated": "2022-08-06",
        "certification_date": "2022-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NY",
            "license": "011746",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "347-997-2691",
            "affiliation": "N",
            "endpointDescription": "Telephone",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "Other",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Other",
            "address_1": "11515 95th Ave",
            "city": "South Richmond Hill",
            "state": "NY",
            "country_code": "US",
            "postal_code": "114191239",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Mental Health Counselor in South Richmond Hill, NY
• Providers in South Richmond Hill, NY by specialty
• Mental Health Counselor in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2022; 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.