Individual provider Active NPI

Luis Suarez, MHC

  • Addiction (Substance Use Disorder) Counselor
  • Port Jefferson Station, NY
National Provider Identifier
1396197315
Registry record updated Mar 7, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
Practice address
34 Ontario St
Port Jefferson Station, NY 11776-4349
Phone
(631) 428-7639
NPI assigned
Jul 2, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X Primary

Addresses

Primary practice location

34 Ontario St
Port Jefferson Station, NY 11776-4349

Mailing address

34 Ontario St
Port Jefferson Station, NY 11776-4349
Phone (631) 428-7639

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240122003642 NY Practitioner - Mental Health Counselor 5294187605 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
New York University School of Medicine, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Family Service League IncGroup PAC ID 4284524448, 47 clinicians

Practice addresses (Care Compare)

320 Carleton Ave
Central Islip, NY 11722-4506
Phone (631) 663-4300

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Family Service League, Inc. CurrentSince Jan 1, 2024 Accepting new patients

Locations

320 Carleton Ave
Central Islip, NY 11722
Phone (631) 234-7807

790 Park Ave
Huntington, NY 11743
Phone (631) 427-3700

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": "1467417600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1551916800000",
    "number": "1396197315",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "34 ONTARIO ST",
            "city": "PORT JEFFERSON STATION",
            "state": "NY",
            "postal_code": "117764349",
            "telephone_number": "631-428-7639"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "34 ONTARIO ST",
            "city": "PORT JEFFERSON STATION",
            "state": "NY",
            "postal_code": "117764349",
            "telephone_number": "631-428-7639"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUAREZ",
        "first_name": "LUIS",
        "credential": "MHC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-07-02",
        "last_updated": "2019-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Jefferson Station, NY

Sources for this page

Verify at the official NPI Registry.