Individual provider Active NPI

Sara Elsehetry, MA, MHC

  • Mental Health Counselor
  • Brooklyn, NY
National Provider Identifier
1346865391
Registry record updated Jun 15, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
P103114 Issued in NY
Practice address
111 Dahlgren PL
Brooklyn, NY 11228-3693
Phone
(718) 745-4588
NPI assigned
Jun 15, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 15, 2020

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 P103114 NY Primary

Addresses

Primary practice location

111 Dahlgren PL
Brooklyn, NY 11228-3693

Mailing address

8891 20TH Ave Apt 2E
Brooklyn, NY 11214-7328
Phone (718) 249-7550

Other identifiers 2

IdentifierTypeStateIssuer
P103114OtherNYDEPARTMENT OF PROFESSIONAL LICENSING
P103114OtherNYDIVISION OF PROFESSIONAL LICENSING

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL Brooklyn

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
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
P103114NYMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1592179200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1592179200000",
    "number": "1346865391",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8891 20TH AVE APT 2E",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112147328",
            "telephone_number": "718-249-7550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 DAHLGREN PL",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112283693",
            "telephone_number": "718-745-4588"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELSEHETRY",
        "first_name": "SARA",
        "credential": "MA, MHC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-06-15",
        "last_updated": "2020-06-15",
        "certification_date": "2020-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NY",
            "license": "P103114",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DEPARTMENT OF PROFESSIONAL LICENSING",
            "identifier": "P103114",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DIVISION OF PROFESSIONAL LICENSING",
            "identifier": "P103114",
            "state": "NY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Brooklyn",
            "affiliation": "N",
            "address_1": "8891 20th Ave Apt 2E",
            "city": "Brooklyn",
            "state": "NY",
            "country_code": "US",
            "postal_code": "112147328",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 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.

Verify at the official NPI Registry.