Individual provider Active NPI

Melissa Archbold, LMHC

  • Mental Health Counselor
  • Brooklyn, NY
National Provider Identifier
1356730907
Registry record updated Jan 21, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
P94648 Issued in NY
Practice address
102 Pilling St
Brooklyn, NY 11207-1610
Phone
(718) 602-1000
Fax
(718) 602-1111
NPI assigned
Jan 21, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 21, 2015

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 P94648 NY Primary

Addresses

Primary practice location

102 Pilling St
Brooklyn, NY 11207-1610

Mailing address

2039 Belmont Ave
Elmont, NY 11003-2950
Phone (516) 451-2964

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

LicenseStateTypeSpecialty
P94648NYMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
New York Psychotherapy and Counseling Center PastSince Dec 6, 2010 Accepting new patients
Coordinated Behavioral Care Ipa Inc Past Accepting new patients

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": "1421798400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1421798400000",
    "number": "1356730907",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2039 BELMONT AVE",
            "city": "ELMONT",
            "state": "NY",
            "postal_code": "110032950",
            "telephone_number": "516-451-2964"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 PILLING ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112071610",
            "telephone_number": "718-602-1000",
            "fax_number": "718-602-1111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ARCHBOLD",
        "first_name": "MELISSA",
        "credential": "LMHC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-01-21",
        "last_updated": "2015-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NY",
            "license": "P94648",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "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 Jan 21, 2015; 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.