Individual provider Active NPI

Deborah Missud, LMHC

  • Mental Health Counselor
  • New York, NY
National Provider Identifier
1306552492
Registry record updated Jan 23, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
13162 Issued in NY
Practice address
1619 3Rd Ave RM 202
New York, NY 10128-3459
Phone
(646) 883-5225
NPI assigned
Jan 23, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 23, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 13162 NY Primary

Addresses

Primary practice location

1619 3Rd Ave RM 202
New York, NY 10128-3459

Mailing address

1619 3Rd Ave RM 202
New York, NY 10128-3459

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Previously, effective Aug 24, 2024 through Aug 24, 2026

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
13162NYMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Deborah Missud Mental Health Counseling PLLC Mental Health CurrentSince Oct 6, 2024 Accepting new patients

Locations

928 Broadway
Ste 503
New York, NY 10010
Phone (646) 883-5225

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1674432000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674432000000",
    "number": "1306552492",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1619 3RD AVE RM 202",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "101283459"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1619 3RD AVE RM 202",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "101283459",
            "telephone_number": "646-883-5225"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MISSUD",
        "first_name": "DEBORAH",
        "credential": "LMHC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-01-23",
        "last_updated": "2023-01-23",
        "certification_date": "2023-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NY",
            "license": "13162",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.