Anthony Gaudioso, PH.D, Licensed Mental Health Counselor, P.C.

Organization Active NPI Mental Health Counselor · Stone Ridge, NY

NPI 1376788604 · NPPES record last updated Aug 2, 2022

Key facts

NPI
1376788604
Entity type
Organization (NPI type 2)
Primary specialty
Mental Health Counselor 101YM0800X
License
000464-1 (NY)
Legal business name
ANTHONY GAUDIOSO, PH.D, LICENSED MENTAL HEALTH COUNSELOR, P.C.
Practice address
695 Buck Rd
Stone Ridge, NY 12484-5500
Phone
(917) 470-9224
Fax
(917) 470-9330
NPI assigned
Dec 16, 2008
Organization subpart
No

Authorized official

Name
Dr. Anthony Gaudioso, LMHC, NCC, PHD
Title
Owner
Phone
(212) 729-1450

Corporate family (same tax ID) 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Enrolled in NY

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20240126003005 NY Part B Supplier - Clinic/Group Practice 8123471034 Receives reassigned benefits from 1 practitioner
Practice locations: Stone Ridge, NY

National Provider Directory

Tax ID family
Anthony Gaudioso PHD Licensed Mental Health Counselor PC (2 organizations share this tax ID)

Locations

79 Saint James St
Kingston, NY 12401
Phone (845) 338-3888

1133 Broadway
Ste 1508
New York, NY 10010
Phone (646) 416-0482

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor
Group: 193400000X SINGLE SPECIALTY GROUP
101YM0800X 000464-1 NY Yes

Addresses

Primary practice location

695 Buck Rd
Stone Ridge, NY 12484-5500

Mailing address

695 Buck Rd
Stone Ridge, NY 12484-5500
Phone (212) 729-1450

Other practice location 1

79 Saint James St
Kingston, NY 12401-4513
Phone (917) 470-9224

Electronic endpoints

TypeEndpointUseAffiliation
Direct Messaging Address drgaudioso@mac.com Direct

Other providers in Stone Ridge, NY

All providers in Stone Ridge, NY · Mental Health Counselor in New York

Sources for this page

Verify at the official NPI Registry.