Kelly Conrad Sanchez, LMFT

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

2091 Issued in NY

Practice address

1000 Main St
Port Jefferson, NY 11777-2250

Phone

(631) 296-1113

NPI assigned

Apr 14, 2023

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Marriage and Family Therapist

Education

Hofstra North Shore - Lij School of Medicine, 2019

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• CS Medical Associates, P.C.

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Farmingville, NY
  • NPI 1992210231
  Medicare reassignment NPD
• CS Medical Associates, P.C.

  • Counselor
  • Amityville, NY
  • NPI 1790653236
  NPD

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

{
    "created_epoch": "1681430400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684195200000",
    "number": "1265128946",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "107 W MAIN ST",
            "city": "EAST ISLIP",
            "state": "NY",
            "postal_code": "117302337",
            "telephone_number": "631-666-1615"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 MAIN ST",
            "city": "PORT JEFFERSON",
            "state": "NY",
            "postal_code": "117772250",
            "telephone_number": "631-296-1113"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "107 W Main St",
            "address_purpose": "LOCATION",
            "city": "East Islip",
            "state": "NY",
            "postal_code": "117302337",
            "country_code": "US",
            "telephone_number": "631-666-1615",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SANCHEZ",
        "first_name": "KELLY",
        "middle_name": "CONRAD",
        "credential": "LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-04-14",
        "last_updated": "2023-05-16",
        "certification_date": "2023-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "NY",
            "license": "2091",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Salim a Matar MD PC
• Samantha Marzano LCSW PC
• Lisa Marie Sammarco, FNP
• Christine Ann Sammy, MS
• Samuel Brown DO, PC
• Mark Sandberg
• Ayush Sangari
• Gerardo Alfredo Sanroman, MD
• Deborah Santos, LMT
• Tyler Santos, MD, MS

• Marriage & Family Therapist in Port Jefferson, NY
• Providers in Port Jefferson, NY by specialty
• Marriage & Family Therapist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.