Lydia Byun, ATR

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

002043 Issued in NY

Practice address

3708 91St St
Suite 3a
Jackson Heights, NY 11372-7961

Phone

(718) 779-2263

NPI assigned

Nov 2, 2016

Last updated

Nov 2, 2016By the provider in NPPES

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

Other identifiers 1

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Mental Health Providers of Western Queens

  • Community/Behavioral Health Agency
  • Jackson Heights, NY
  • NPI 1104200294
  NPD (past)

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

{
    "created_epoch": "1478044800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1478044800000",
    "number": "1316499767",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "90 MESEROLE ST",
            "address_2": "APT 1B",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112062397",
            "telephone_number": "973-600-9013"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3708 91ST ST",
            "address_2": "SUITE 3A",
            "city": "JACKSON HEIGHTS",
            "state": "NY",
            "postal_code": "113727961",
            "telephone_number": "718-779-2263"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BYUN",
        "first_name": "LYDIA",
        "credential": "ATR",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-11-02",
        "last_updated": "2016-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NY",
            "license": "002043",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EMPIRE BLUE CROSS BLUE SHIELD NY ESSENTIAL PLAN",
            "identifier": "JLJ721666467",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Mental Health Counselor in Jackson Heights, NY
• Providers in Jackson Heights, 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 Nov 2, 2016; 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.