Individual provider Active NPI

Grace Too Shao Wang, LMHC, CASACT

  • Mental Health Counselor
  • Saint Albans, NY
National Provider Identifier
1366627317
Registry record updated May 31, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
004478-1 Issued in NY
Practice address
18843 120TH Rd
Saint Albans, NY 11412
Phone
(347) 649-5212
NPI assigned
Jan 8, 2008
Last updated
May 31, 2018By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 31, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 004478-1 NY Primary
Addiction (Substance Use Disorder) Counselor 101YA0400X 29886 NY

Addresses

Primary practice location

18843 120TH Rd
Saint Albans, NY 11412

Mailing address

18843 120TH Rd
Saint Albans, NY 11412-3616
Phone (347) 649-5212

Other names 1

  • Grace Too Shao Former name

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
I20240122004058 NY Practitioner - Mental Health Counselor 1456703768 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Child Center of Ny IncGroup PAC ID 8426010638, 15 clinicians

Practice addresses (Care Compare)

14015 Sanford Ave
Suite B
Flushing, NY 11355-2688
Phone (718) 358-8288

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
29886NYMDAddiction (Substance Use Disorder) Counselor
004478-1NYMDMental Health Counselor
004478NYMDAcupuncturist

Practice roles

OrganizationSpecialtyStatusNew patients
The Child Center of Ny, Inc. CurrentSince Jan 1, 2024 Accepting new patients

Locations

14015 Sanford Ave
Ste B
Flushing, NY 11355
Phone (718) 450-9242

11835 Queens Blvd
Fl 6
Forest Hills, NY 11375
Phone (718) 851-7770

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1199750400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1527724800000",
    "number": "1366627317",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18843 120TH RD",
            "city": "SAINT ALBANS",
            "state": "NY",
            "postal_code": "114123616",
            "telephone_number": "347-649-5212"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18843 120TH RD",
            "city": "SAINT ALBANS",
            "state": "NY",
            "postal_code": "11412",
            "telephone_number": "347-649-5212"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WANG",
        "first_name": "GRACE",
        "middle_name": "TOO SHAO",
        "credential": "LMHC, CASACT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-01-08",
        "last_updated": "2018-05-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NY",
            "license": "004478-1",
            "primary": true
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NY",
            "license": "29886",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "GRACE",
            "last_name": "SHAO",
            "middle_name": "TOO",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Saint Albans, NY

Sources for this page

Verify at the official NPI Registry.