Individual provider Active NPI

Romona Yizar, LMHC

  • Counselor
  • Middletown, NY
National Provider Identifier
1356995302
Registry record updated Jul 29, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
License
009699 Issued in NY
Practice address
15 Fortune Rd W
Middletown, NY 10941-1625
Phone
(845) 240-7707
NPI assigned
Jul 29, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X 009699 NY Primary

Addresses

Primary practice location

15 Fortune Rd W
Middletown, NY 10941-1625

Mailing address

15 Fortune Rd W
Middletown, NY 10941-1625
Phone (845) 240-7707

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240122002161 NY Practitioner - Mental Health Counselor 1456703826 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Access: Supports for Living Inc CurrentSince Jan 1, 2024 Accepting new patients
Access: Supports for Living Inc. CurrentSince Jan 1, 2024 Accepting new patients

Locations

67 Windsor Hwy
Newburgh, NY 12553
Phone (845) 562-6850

15 Fortune Rd W
Scotchtown, NY 10941
Phone (845) 673-7123

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": "1564358400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1564358400000",
    "number": "1356995302",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 FORTUNE RD W",
            "city": "MIDDLETOWN",
            "state": "NY",
            "postal_code": "109411625",
            "telephone_number": "845-240-7707"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 FORTUNE RD W",
            "city": "MIDDLETOWN",
            "state": "NY",
            "postal_code": "109411625",
            "telephone_number": "845-240-7707"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YIZAR",
        "first_name": "ROMONA",
        "credential": "LMHC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-29",
        "last_updated": "2019-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "NY",
            "license": "009699",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Middletown, NY

Sources for this page

Verify at the official NPI Registry.