Individual provider Active NPI

Patricia A Otoole, LMHC

  • Mental Health Counselor
  • Hollis, NY
National Provider Identifier
1245350628
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
001269 Issued in NY
Practice address
20507 Hillside Ave
Suite 5-9
Hollis, NY 11423-2220
Phone
(718) 264-1749
Fax
(718) 465-8423
NPI assigned
Mar 30, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 001269 NY Primary

Addresses

Primary practice location

20507 Hillside Ave
Suite 5-9
Hollis, NY 11423-2220

Mailing address

222 Arleigh Rd
Douglaston, NY 11363-1143
Phone (718) 631-4130

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

LicenseStateTypeSpecialty
001269NYMDPhysician Assistant

NPI Registry JSON

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

{
    "created_epoch": "1175212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1245350628",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "222 ARLEIGH RD",
            "city": "DOUGLASTON",
            "state": "NY",
            "postal_code": "113631143",
            "telephone_number": "718-631-4130",
            "fax_number": "917-183-5823"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20507 HILLSIDE AVE",
            "address_2": "SUITE 5-9",
            "city": "HOLLIS",
            "state": "NY",
            "postal_code": "114232220",
            "telephone_number": "718-264-1749",
            "fax_number": "718-465-8423"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OTOOLE",
        "first_name": "PATRICIA",
        "middle_name": "A",
        "credential": "LMHC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-30",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NY",
            "license": "001269",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hollis, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.