Kaitlynn B. Cornell-Mullane, LCAT, RDT, MA

Primary specialty

Drama TherapistTaxonomy code 101200000X

License

002579 Issued in NY

Practice address

802 Seneca Ave Apt 3L
Ridgewood, NY 11385-4810

Phone

(845) 901-2799

NPI assigned

May 4, 2021

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other names 1

• Kaitlynn B. Cornell Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

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

{
    "created_epoch": "1620086400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715126400000",
    "number": "1285217547",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "802 SENECA AVE APT 3L",
            "city": "RIDGEWOOD",
            "state": "NY",
            "postal_code": "113854810",
            "telephone_number": "845-901-2799"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "802 SENECA AVE APT 3L",
            "city": "RIDGEWOOD",
            "state": "NY",
            "postal_code": "113854810",
            "telephone_number": "845-901-2799"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "352 7th Ave Apt 3L",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100015012",
            "country_code": "US",
            "telephone_number": "845-901-2799",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1025 Seneca Ave",
            "address_purpose": "LOCATION",
            "city": "Ridgewood",
            "state": "NY",
            "postal_code": "113855800",
            "country_code": "US",
            "telephone_number": "845-901-2799",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CORNELL-MULLANE",
        "first_name": "KAITLYNN",
        "middle_name": "B.",
        "credential": "LCAT, RDT, MA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-05-04",
        "last_updated": "2024-05-08",
        "certification_date": "2024-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NY",
            "license": "002579",
            "primary": false
        },
        {
            "code": "221700000X",
            "taxonomy_group": "",
            "desc": "Art Therapist",
            "state": "NY",
            "license": "002579",
            "primary": false
        },
        {
            "code": "101200000X",
            "taxonomy_group": "",
            "desc": "Drama Therapist",
            "state": "NY",
            "license": "002579",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KAITLYNN",
            "last_name": "CORNELL",
            "middle_name": "B.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Elena Cojocaru, NP
• Doina Coman, DDS
• Giovanni Como Jr., PHARMD
• Complete Care Medical of N.Y. P.C.
• Courtney Cookman, LCSW
• Catherine Mary Corrigan, ANP
• Sandra Catalina Cortes, SA-C
• Doris Corujo, RN
• Lauren Victoria Court
• Silvia Orestia Crainiciuc

• Drama Therapist in Ridgewood, NY
• Providers in Ridgewood, NY by specialty
• Drama Therapist in New York

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