Emilia Jerez
Individual provider Active NPI Mental Health Counselor · Brooklyn, NY
NPI 1285289348 · NPPES record last updated Oct 11, 2024
Key facts
- NPI
- 1285289348
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Mental Health Counselor 101YM0800X
- License
- 015203 (NY)
- Practice address
- 1623 Kings Hwy
Brooklyn, NY 11229-1209 - Phone
- (718) 954-3800
- NPI assigned
- Aug 6, 2019
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 3
Medicare Care Compare profile
- Specialty
- Mental Health Counselor
- Education
- Other, 2020
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Interborough Developmental and Consultation Center Inc
Supportive Care Psychology of Ny PC
Practice addresses (Care Compare)
1623 Kings Hwy
Brooklyn, NY 11229-1209
Phone 9292737601426
7 Keeler Ave
Moravia, NY 13118-3688
Phone (732) 797-9387
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NY
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20241114002332 | NY | Practitioner - Mental Health Counselor | 8729512694 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Supportive Care Psychology of Ny PC | Current |
Accepting new patients | |
| Interborough Developmental and Consultation Center, Inc. | Current |
Accepting new patients | |
| Interborough Developmental and Consultation Center, Inc. | Current |
Accepting new patients |
Locations
27 Randolph Rd
Howell, NJ 07731
Phone (972) 677-7951
1623 Kings Hwy
Brooklyn, NY 11229
Phone (718) 307-6800
7810 164th St
Fresh Meadows, NY 11366
Phone (718) 429-2200
170 Lake St
Liberty, NY 12754
Phone (845) 292-4200
7 Keeler Ave
Moravia, NY 13118
Phone (315) 497-0440
330 Chestnut St
Oneonta, NY 13820
Phone (607) 432-8500
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Mental Health Counselor | 101YM0800X | 015203 | NY | Yes |
Addresses
Primary practice location
1623 Kings Hwy
Brooklyn, NY 11229-1209
Mailing address
1623 Kings Hwy
Brooklyn, NY 11229-1209
Phone (718) 954-3800
Other providers in Brooklyn, NY
- Renee Camielle Jeremiah
- Branny Jeremias Reiner
- Renee Jeremias
- Kender Jeremie
- Jeremy Schwartz LCSW PLLC
- Lilliana Jerez
- Jericho Medical Care PC
- Sharon Jerido
- Yelena Jernigan
- Jerome & Milton Rosenblum Inc
All providers in Brooklyn, NY · Mental Health Counselor in New York
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 11, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.