Organization Active NPI

Mountainview Counseling and Psychological Services, PC

  • Psychologist
  • Holbrook, NY
National Provider Identifier
1356475107
Registry record updated Sep 28, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
Legal business name
MOUNTAINVIEW COUNSELING AND PSYCHOLOGICAL SERVICES, PC
Practice address
4250 Veterans Memorial Hwy
Suite 215 East
Holbrook, NY 11741-4000
Phone
(631) 981-5762
Fax
(631) 981-5762
NPI assigned
Mar 15, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 28, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Kim Hescheles
Title
Psychologist
Phone
(631) 981-5762

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103T00000X Primary

Addresses

Primary practice location

4250 Veterans Memorial Hwy
Suite 215 East
Holbrook, NY 11741-4000

Mailing address

4250 Veterans Memorial Hwy
Suite 215 East
Holbrook, NY 11741-4000
Phone (631) 981-5762

Other identifiers 1

IdentifierTypeStateIssuer
01625167MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090501000093 NY Part B Supplier - Clinic/Group Practice 8123176146 Receives reassigned benefits from 2 practitioners
Practice locations: Holbrook, NY; Oakdale, NY

National Provider Directory

National Provider Directory

Locations

4250 Veterans Memorial Hwy
Ste 215E
Holbrook, NY 11741
Phone (516) 594-0193

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1173916800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1190937600000",
    "number": "1356475107",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4250 VETERANS MEMORIAL HWY",
            "address_2": "SUITE 215 EAST",
            "city": "HOLBROOK",
            "state": "NY",
            "postal_code": "117414000",
            "telephone_number": "631-981-5762",
            "fax_number": "631-981-5762"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4250 VETERANS MEMORIAL HWY",
            "address_2": "SUITE 215 EAST",
            "city": "HOLBROOK",
            "state": "NY",
            "postal_code": "117414000",
            "telephone_number": "631-981-5762",
            "fax_number": "631-981-5762"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOUNTAINVIEW COUNSELING AND PSYCHOLOGICAL SERVICES, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-15",
        "last_updated": "2007-09-28",
        "status": "A",
        "authorized_official_last_name": "HESCHELES",
        "authorized_official_first_name": "KIM",
        "authorized_official_title_or_position": "PSYCHOLOGIST",
        "authorized_official_telephone_number": "631-981-5762",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01625167",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Holbrook, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.