Active NPI
Jessica Ancona-Neis, CAT
- Art Therapist
- Glen Cove, NY
National Provider Identifier
1346862968
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Art Therapist
- License
- 104975-01
- Practice address
- 113 Glen Cove Ave
Glen Cove, NY 11542-3438 - Phone
- (516) 676-2388
- Fax
- (516) 759-5259
- NPI assigned
- May 18, 2020
- 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 |
|---|---|---|---|---|
| Art Therapist | 221700000X | 104975-01 | NY | Primary |
Addresses
Primary practice location
113 Glen Cove Ave
Glen Cove, NY 11542-3438
Mailing address
937 Victory Blvd
Staten Island, NY 10301-3704
Phone (516) 676-2388
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 104975-01 | NY | MD | Art Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1589760000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1589760000000",
"number": "1346862968",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "937 VICTORY BLVD",
"city": "STATEN ISLAND",
"state": "NY",
"postal_code": "103013704",
"telephone_number": "516-676-2388",
"fax_number": "516-759-5259"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "113 GLEN COVE AVE",
"city": "GLEN COVE",
"state": "NY",
"postal_code": "115423438",
"telephone_number": "516-676-2388",
"fax_number": "516-759-5259"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ANCONA-NEIS",
"first_name": "JESSICA",
"credential": "CAT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-05-18",
"last_updated": "2020-05-18",
"certification_date": "2020-05-18",
"status": "A"
},
"taxonomies": [
{
"code": "221700000X",
"taxonomy_group": "",
"desc": "Art Therapist",
"state": "NY",
"license": "104975-01",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Glen Cove, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.