Individual provider Active NPI

Sundeese Borden, LMHC, MA

  • Mental Health Counselor
  • Fresh Meadows, NY
National Provider Identifier
1366821332
Registry record updated Sep 26, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
006224 Issued in NY
Practice address
6143 186TH St
Fresh Meadows, NY 11365-2710
Phone
(718) 593-3599
NPI assigned
May 23, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 26, 2016

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 006224 NY Primary

Addresses

Primary practice location

6143 186TH St
Fresh Meadows, NY 11365-2710

Mailing address

PO Box 656797
Fresh Meadows, NY 11365-6797
Phone (718) 593-3599

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
006224NYMDMental Health Counselor

Networks

  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722

NPI Registry JSON

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

{
    "created_epoch": "1432339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1474848000000",
    "number": "1366821332",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 656797",
            "city": "FRESH MEADOWS",
            "state": "NY",
            "postal_code": "113656797",
            "telephone_number": "718-593-3599"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6143 186TH ST",
            "city": "FRESH MEADOWS",
            "state": "NY",
            "postal_code": "113652710",
            "telephone_number": "718-593-3599"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BORDEN",
        "first_name": "SUNDEESE",
        "name_prefix": "Ms.",
        "credential": "LMHC, MA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-05-23",
        "last_updated": "2016-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NY",
            "license": "006224",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fresh Meadows, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2016; 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.