Organization Active NPI

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

  • Mental Health Counselor
  • Stone Ridge, NY
National Provider Identifier
1376788604
Registry record updated Aug 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
000464-1 Issued in 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
Last updated
Aug 2, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 2, 2022

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

Authorized official

Name
Dr. Anthony Gaudioso, LMHC, NCC, PHDNPI 1083684096
Title
Owner
Phone
(212) 729-1450

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YM0800X 000464-1 NY Primary

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 1

TypeEndpointUseAffiliation
Direct Messaging Address drgaudioso@mac.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

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

National Provider Directory
Tax ID family
Anthony Gaudioso PHD Licensed Mental Health Counselor PC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Locations

79 Saint James St
Kingston, NY 12401
Phone (845) 768-2295

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

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1229385600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1659398400000",
    "number": "1376788604",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "695 BUCK RD",
            "city": "STONE RIDGE",
            "state": "NY",
            "postal_code": "124845500",
            "telephone_number": "212-729-1450",
            "fax_number": "917-470-9330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "695 BUCK RD",
            "city": "STONE RIDGE",
            "state": "NY",
            "postal_code": "124845500",
            "telephone_number": "917-470-9224",
            "fax_number": "917-470-9330"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "79 Saint James St",
            "address_purpose": "LOCATION",
            "city": "Kingston",
            "state": "NY",
            "postal_code": "124014513",
            "country_code": "US",
            "telephone_number": "917-470-9224",
            "fax_number": "917-470-9330",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "ANTHONY GAUDIOSO, PH.D, LICENSED MENTAL HEALTH COUNSELOR, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-12-16",
        "last_updated": "2022-08-02",
        "certification_date": "2022-08-02",
        "status": "A",
        "authorized_official_last_name": "GAUDIOSO",
        "authorized_official_first_name": "ANTHONY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "212-729-1450",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "LMHC, NCC, PHD"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": "NY",
            "license": "000464-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "drgaudioso@mac.com",
            "affiliation": "N",
            "endpointDescription": "emaIL",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "695 Buck Rd",
            "city": "Stone Ridge",
            "state": "NY",
            "country_code": "US",
            "postal_code": "124845500",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Stone Ridge, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.