Active NPI
Yvette A. Fuerderer, LMHC
- Mental Health Counselor
- Shoreham, NY
National Provider Identifier
1396990750
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 004480
- Practice address
- 153 Randall Rd
Shoreham, NY 11786-2339 - Phone
- (631) 255-8872
- NPI assigned
- Nov 25, 2008
- Last updated
- Jun 23, 2011
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 004480 | NY | Primary |
Addresses
Primary practice location
153 Randall Rd
Shoreham, NY 11786-2339
Mailing address
153 Randall Rd
Shoreham, NY 11786-2339
Phone (631) 255-8872
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Previously, effective Aug 2, 2024 through Aug 2, 2026
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 004480 | NY | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1227571200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1308787200000",
"number": "1396990750",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "153 RANDALL RD",
"city": "SHOREHAM",
"state": "NY",
"postal_code": "117862339",
"telephone_number": "631-255-8872"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "153 RANDALL RD",
"city": "SHOREHAM",
"state": "NY",
"postal_code": "117862339",
"telephone_number": "631-255-8872"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FUERDERER",
"first_name": "YVETTE",
"middle_name": "A.",
"name_prefix": "Ms.",
"credential": "LMHC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-11-25",
"last_updated": "2011-06-23",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "NY",
"license": "004480",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Shoreham, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.