Individual provider Active NPI

Angelica Maria Calderon

  • Mental Health Counselor
  • Bronx, NY
National Provider Identifier
1336739275
Registry record updated Jan 25, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
P107651 Issued in NY
Practice address
560 Southern Blvd
Bronx, NY 10455-3715
Phone
(646) 618-8913
NPI assigned
Jan 25, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 25, 2021

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 P107651 NY Primary

Addresses

Primary practice location

560 Southern Blvd
Bronx, NY 10455-3715

Mailing address

4215 Park Ave Apt 6Z
Bronx, NY 10457-6060
Phone (646) 573-8187

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
P107651NYMDMental Health Counselor
014093NYMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
The Educational Alliance, Inc. CurrentSince Apr 28, 2024 Accepting new patients

Locations

197 E Broadway
New York, NY 10002
Phone (212) 780-2300

Interoperability endpoints

  • FHIR API: https://app.meldrx.com/api/fhir/aura_educational_alliance

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": "1611532800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611532800000",
    "number": "1336739275",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4215 PARK AVE APT 6Z",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104576060",
            "telephone_number": "646-573-8187"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "560 SOUTHERN BLVD",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104553715",
            "telephone_number": "646-618-8913"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CALDERON",
        "first_name": "ANGELICA",
        "middle_name": "MARIA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-01-25",
        "last_updated": "2021-01-25",
        "certification_date": "2021-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NY",
            "license": "P107651",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

Verify at the official NPI Registry.