Individual provider Active NPI

Katelyn Rose Ginley, LMHC

  • Mental Health Counselor
  • Wantagh, NY
National Provider Identifier
1386280857
Registry record updated Nov 20, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
1400 Wantagh Ave Ste 104
Wantagh, NY 11793-2257
Phone
(631) 321-7011
Fax
(631) 669-8532
NPI assigned
Nov 20, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 20, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X Primary

Addresses

Primary practice location

1400 Wantagh Ave Ste 104
Wantagh, NY 11793-2257

Mailing address

17 Fordham Rd
West Babylon, NY 11704-5803
Phone (631) 321-7011

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

Practice roles

OrganizationSpecialtyStatusNew patients
Heart & Soul Community Counseling CurrentSince Nov 24, 2019 Accepting new patients

Locations

17 Fordham Rd
West Babylon, NY 11704
Phone (631) 321-7011

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1574208000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1574208000000",
    "number": "1386280857",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17 FORDHAM RD",
            "city": "WEST BABYLON",
            "state": "NY",
            "postal_code": "117045803",
            "telephone_number": "631-321-7011",
            "fax_number": "631-669-8532"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 WANTAGH AVE STE 104",
            "city": "WANTAGH",
            "state": "NY",
            "postal_code": "117932257",
            "telephone_number": "631-321-7011",
            "fax_number": "631-669-8532"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GINLEY",
        "first_name": "KATELYN",
        "middle_name": "ROSE",
        "credential": "LMHC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-11-20",
        "last_updated": "2019-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wantagh, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2019; 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.