Active NPI
Kieran Gillespie
- Mental Health Counselor
- Oceanside, NY
National Provider Identifier
1275124810
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- P118483
- Practice address
- 71 Homecrest CT
Oceanside, NY 11572-2209 - Phone
- (516) 766-6283
- NPI assigned
- Jan 27, 2021
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Mental Health Counselor | 101YM0800X | P118483 | NY | Primary |
Addresses
Primary practice location
71 Homecrest CT
Oceanside, NY 11572-2209
Mailing address
71 Homecrest CT
Oceanside, NY 11572-2209
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| P118483 | NY | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1611705600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1665705600000",
"number": "1275124810",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "71 HOMECREST CT",
"city": "OCEANSIDE",
"state": "NY",
"postal_code": "115722209"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "71 HOMECREST CT",
"city": "OCEANSIDE",
"state": "NY",
"postal_code": "115722209",
"telephone_number": "516-766-6283"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GILLESPIE",
"first_name": "KIERAN",
"name_prefix": "Mr.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-01-27",
"last_updated": "2022-10-14",
"certification_date": "2022-10-14",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "NY",
"license": "P118483",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Oceanside, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2022; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.