Annie Jan, LMHC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

010658 Issued in NY

Practice address

211 Broadway Ste 207
Lynbrook, NY 11563-3290

Phone

(516) 825-6567

NPI assigned

Oct 12, 2020

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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.

• Biofeedback, Mental Health Counseling and Creative Arts Therapy, PLLC

  • Mental Health Counselor
  • Lynbrook, NY
  • NPI 1851896997
  NPD (past)
• Expressive Connections Mental Health Counseling, PLLC

  • Adolescent and Children Mental Health Clinic/Center
  • Lynbrook, NY
  • NPI 1548876790
  NPD (past)

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

{
    "created_epoch": "1602460800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602460800000",
    "number": "1306444302",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7552 183RD ST",
            "city": "FRESH MEADOWS",
            "state": "NY",
            "postal_code": "113661618",
            "telephone_number": "917-929-7806"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "211 BROADWAY STE 207",
            "city": "LYNBROOK",
            "state": "NY",
            "postal_code": "115633290",
            "telephone_number": "516-825-6567"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAN",
        "first_name": "ANNIE",
        "credential": "LMHC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-10-12",
        "last_updated": "2020-10-12",
        "certification_date": "2020-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": "NY",
            "license": "010658",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Mental Health Counselor in Lynbrook, NY
• Providers in Lynbrook, NY by specialty
• Mental Health Counselor in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2020; 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.