Jessica Lyko

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

Practice address

123 Pike St
Port Jervis, NY 12771-1824

Phone

(845) 856-7576

Fax

(845) 383-8010

NPI assigned

Aug 28, 2014

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1409184000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655683200000",
    "number": "1407256365",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "123 PIKE ST",
            "city": "PORT JERVIS",
            "state": "NY",
            "postal_code": "127711824",
            "telephone_number": "845-856-7576",
            "fax_number": "845-383-8010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "123 PIKE ST",
            "city": "PORT JERVIS",
            "state": "NY",
            "postal_code": "127711824",
            "telephone_number": "845-856-7576",
            "fax_number": "845-383-8010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LYKO",
        "first_name": "JESSICA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-08-28",
        "last_updated": "2022-06-20",
        "certification_date": "2022-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NY",
            "license": "108127-01",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1007592970029",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Karen Ann Little, M.S.P.T.
• Roselle Aguila Little, FNP-C
• Sara J. Little, MD
• Emmanuel Llado, MD
• Emmanise Louis I, FNP
• Dipti U Maniar, DDS
• Nicole Manzare
• Kenneth Manzo, R.PH.
• Marian Susan Sanborn LCSW PLLC
• Zaharoula Maris, D.M.D.

• Addiction (Substance Use Disorder) Counselor in Port Jervis, NY
• Providers in Port Jervis, NY by specialty
• Addiction (Substance Use Disorder) Counselor in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2022; 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.