Jordan Hailey Boston, LMHC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

013104 Issued in NY

Practice address

620 Route 303
Blauvelt, NY 10913-1170

Phone

(845) 353-2730

Fax

(845) 353-2358

NPI assigned

Mar 23, 2023

Last updated

Mar 23, 2023By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

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.

• Coordinated Behavioral Care Ipa Inc

  • Multi-Specialty Clinic/Center
  • Bronx, NY
  • NPI 1457881443
  NPD (past)
• Samaritan Daytop Village, Inc.

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Blauvelt, NY
  • NPI 1134240344
  NPD (past)

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

{
    "created_epoch": "1679529600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679529600000",
    "number": "1376246926",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40 CRANBERRY DR",
            "city": "HIGHLAND MILLS",
            "state": "NY",
            "postal_code": "109302203",
            "telephone_number": "845-325-9189"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "620 ROUTE 303",
            "city": "BLAUVELT",
            "state": "NY",
            "postal_code": "109131170",
            "telephone_number": "845-353-2730",
            "fax_number": "845-353-2358"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOSTON",
        "first_name": "JORDAN",
        "middle_name": "HAILEY",
        "credential": "LMHC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-03-23",
        "last_updated": "2023-03-23",
        "certification_date": "2023-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NY",
            "license": "013104",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Roland Bartolomucci, M.S. CCC-SLP
• Devon Louise Bibb, LMSW
• Blauvelt Acupuncture PC
• Steven Block
• Sharon M. Borel, LMSV
• Kathleen Boyanski
• Jenna Brady
• Phylis T. Brancaleoni, L.M.S.W., C.A.S.A.C.
• Jillian Brancatelli
• Jacqueline Margaret Carroll, PT

• Mental Health Counselor in Blauvelt, NY
• Providers in Blauvelt, NY by specialty
• Mental Health Counselor in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2023; 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.