Chanel V. Tazza, Mental Health Counseling, P.C.

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Legal business name

CHANEL V. TAZZA, MENTAL HEALTH COUNSELING, P.C.

Doing business as

Awaken Wellness

Practice address

63 Scudders LN
Glen Head, NY 11545-1535

Phone

(646) 456-0819

NPI assigned

Nov 29, 2018

Last updated

Mar 28, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Chanel Viviana Tazza, LMHCNPI 1053510354

Title

Mental Health Counselor/Owner

Phone

(646) 456-0819

Specialties & licenses 1

Addresses

Other identifiers 3

Other names 1

• Awaken Wellness Doing business as

Electronic endpoints 2

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Interoperability endpoints

• Direct secure messaging: chanelt@awakenwellnessnyc.kareodirect.com

Practitioners 8

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.

• Chanel Viviana Tazza, LMHC

  • Mental Health Counselor
  • Ridgewood, NY
  • NPI 1053510354
  Medicare reassignment NPD Authorized official
• Mira Vasjari

  • Mental Health Counselor
  • Ridgewood, NY
  • NPI 1376140467
  Medicare reassignment NPD
• Violeta Bangiyev

  • Mental Health Counselor
  • Ridgewood, NY
  • NPI 1801507983
  NPD
• Fatima Andrea Cabrera

  • Student in an Organized Health Care Education/Training Program
  • Ridgewood, NY
  • NPI 1518563188
  NPD
• Noemi Ferres

  • Mental Health Counselor
  • Ridgewood, NY
  • NPI 1225645088
  NPD
• Unique Grier

  • Mental Health Counselor
  • Ridgewood, NY
  • NPI 1376144170
  NPD
• Sydney Cohen

  • Mental Health Counselor
  • Glen Cove, NY
  • NPI 1861008435
  NPD (past)
• Montserrat Contreras Antoine, MHC-LP

  • Mental Health Counselor
  • Brooklyn, NY
  • NPI 1295377794
  NPD (past)

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

{
    "created_epoch": "1543449600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1711584000000",
    "number": "1386114692",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "63 SCUDDERS LN",
            "city": "GLEN HEAD",
            "state": "NY",
            "postal_code": "115451535",
            "telephone_number": "646-456-0819"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "63 SCUDDERS LN",
            "city": "GLEN HEAD",
            "state": "NY",
            "postal_code": "115451535",
            "telephone_number": "646-456-0819"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5913 Grove St",
            "address_purpose": "LOCATION",
            "city": "Ridgewood",
            "state": "NY",
            "postal_code": "113852647",
            "country_code": "US",
            "telephone_number": "646-456-0819",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "CHANEL V. TAZZA, MENTAL HEALTH COUNSELING, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-11-29",
        "last_updated": "2024-03-28",
        "certification_date": "2024-03-28",
        "status": "A",
        "authorized_official_last_name": "TAZZA",
        "authorized_official_first_name": "CHANEL",
        "authorized_official_middle_name": "VIVIANA",
        "authorized_official_title_or_position": "MENTAL HEALTH COUNSELOR/OWNER",
        "authorized_official_telephone_number": "646-456-0819",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LMHC"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP PRACTICE NPI",
            "identifier": "1386114692",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "07679601",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI TYPE I",
            "identifier": "1053510354",
            "state": "NY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ChanelT@awakenwellnessnyc.kareodirect.com",
            "affiliation": "N",
            "endpointDescription": "EHR",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CSV, PDF",
            "address_1": "5913 Grove St",
            "city": "Ridgewood",
            "state": "NY",
            "country_code": "US",
            "postal_code": "113852647",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "info@awakenwellnessnyc.com",
            "affiliation": "N",
            "address_1": "63 Scudders Ln",
            "city": "Glen Head",
            "state": "NY",
            "country_code": "US",
            "postal_code": "115451535",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Awaken Wellness",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Awaken Wellness",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Susan Elizabeth Capuder, OTRL
• Pamela Carlucci, RN
• Myles A Carter, DDS DENTIST
• Fernando Cavalcante Krause, PHD
• Wendy Chaite, JD, LMHC
• Charles Evans Center, Inc.
• Novneet Singh Chhabra, D.P.M
• Karen Chrappa, P.T.
• Christine M Cirnigliaro, RN
• Comprehensive Neurological Care of Long Island PC

• Mental Health Counselor in Glen Head, NY
• Providers in Glen Head, 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 28, 2024; 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.