Individual provider Active NPI

Samuel Edeson

  • Mental Health Counselor
  • Brooklyn, NY
National Provider Identifier
1326527805
Registry record updated Aug 7, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
1268 E 14TH St
Brooklyn, NY 11230-5241
Phone
(718) 382-0045
Fax
(718) 382-0051
NPI assigned
Aug 7, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 7, 2018

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 Primary

Addresses

Primary practice location

1268 E 14TH St
Brooklyn, NY 11230-5241

Mailing address

1268 E 14TH St
Brooklyn, NY 11230-5241
Phone (718) 382-0045

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250430001588 NY Practitioner - Mental Health Counselor 5395261531 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
013414NYMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Hasc Diagnostic &Treatment Center, Inc CurrentSince Feb 22, 2025 Accepting new patients
Hasc Diagnostic & Treatment Center, Inc CurrentSince Feb 22, 2025 Accepting new patients

Locations

5601 1st Ave
Brooklyn, NY 11220
Phone (718) 650-0110

1221 E 14th St
Brooklyn, NY 11230
Phone (718) 434-4600

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H1722

Organizations & group practices 2

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": "1533600000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1533600000000",
    "number": "1326527805",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1268 E 14TH ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112305241",
            "telephone_number": "718-382-0045",
            "fax_number": "718-382-0051"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1268 E 14TH ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112305241",
            "telephone_number": "718-382-0045",
            "fax_number": "718-382-0051"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDESON",
        "first_name": "SAMUEL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-08-07",
        "last_updated": "2018-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.