Active NPI
Siobhan Fahy
- Mental Health Counselor
- Kingston, NY
National Provider Identifier
1316654619
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 012912-01
- Practice address
- 291 Wall St
Kingston, NY 12401-3849 - Phone
- (845) 768-3595
- NPI assigned
- Nov 4, 2022
- Last updated
- Nov 4, 2022
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 012912-01 | NY | Primary |
Addresses
Primary practice location
291 Wall St
Kingston, NY 12401-3849
Mailing address
58 S Manheim Blvd Apt 59
New Paltz, NY 12561-2466
Phone (917) 584-4992
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Jan 20, 2025 through Jan 20, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 012912-01 | NY | MD | Mental Health Counselor |
| 012912 | NY | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sarah Perl, LCSW PLLC | Past | Accepting new patients |
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1667520000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1667520000000",
"number": "1316654619",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "58 S MANHEIM BLVD APT 59",
"city": "NEW PALTZ",
"state": "NY",
"postal_code": "125612466",
"telephone_number": "917-584-4992"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "291 WALL ST",
"city": "KINGSTON",
"state": "NY",
"postal_code": "124013849",
"telephone_number": "845-768-3595"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FAHY",
"first_name": "SIOBHAN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-11-04",
"last_updated": "2022-11-04",
"certification_date": "2022-11-04",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "NY",
"license": "012912-01",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Kingston, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.