Active NPI
Jordyn Modelevsky
- Mental Health Counselor
- Mamaroneck, NY
National Provider Identifier
1376360651
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- P131285
- Practice address
- 444 E Boston Post Rd Ste 206
Mamaroneck, NY 10543-3704 - Phone
- (917) 974-5892
- NPI assigned
- Sep 26, 2024
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | P131285 | NY | Primary |
Addresses
Primary practice location
444 E Boston Post Rd Ste 206
Mamaroneck, NY 10543-3704
Mailing address
300 Grand St Apt 532
Hoboken, NJ 07030-2744
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
| License | State | Type | Specialty |
|---|---|---|---|
| P131285 | NY | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1727308800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1727308800000",
"number": "1376360651",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "300 GRAND ST APT 532",
"city": "HOBOKEN",
"state": "NJ",
"postal_code": "070302744"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "444 E BOSTON POST RD STE 206",
"city": "MAMARONECK",
"state": "NY",
"postal_code": "105433704",
"telephone_number": "917-974-5892"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MODELEVSKY",
"first_name": "JORDYN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-09-26",
"last_updated": "2024-09-26",
"certification_date": "2024-09-26",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "NY",
"license": "P131285",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mamaroneck, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.