Surafel Getachew, CASAC-T

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

39412 Issued in NY

Practice address

9114 37TH Ave
Jackson Heights, NY 11372-7920

Phone

(718) 779-1600

Fax

(347) 612-4162

NPI assigned

Dec 16, 2024

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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": "1734307200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734307200000",
    "number": "1245047943",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "507 MARSHALL CT",
            "city": "UNIONDALE",
            "state": "NY",
            "postal_code": "115532111",
            "telephone_number": "516-461-7384"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9114 37TH AVE",
            "city": "JACKSON HEIGHTS",
            "state": "NY",
            "postal_code": "113727920",
            "telephone_number": "718-779-1600",
            "fax_number": "347-612-4162"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GETACHEW",
        "first_name": "SURAFEL",
        "name_prefix": "Mr.",
        "credential": "CASAC-T",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-12-16",
        "last_updated": "2024-12-16",
        "certification_date": "2024-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": "NY",
            "license": "CRPA-5634",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NY",
            "license": "39412",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Addiction (Substance Use Disorder) Counselor in Jackson Heights, NY
• Providers in Jackson Heights, NY by specialty
• Addiction (Substance Use Disorder) Counselor in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 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.