The Echelon Society Inc

Primary specialty

Peer SpecialistTaxonomy code 175T00000X

Legal business name

THE ECHELON SOCIETY INC

Practice address

20 E 1St St Ste 302
Mount Vernon, NY 10550-3375

Phone

(914) 219-4239

Fax

(914) 221-7805

NPI assigned

Jul 26, 2021

Organization subpart

No

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

Authorized official

Name

Mr. Michael D Fernandes, CRPA

Title

President & Founder

Phone

(149) 219-4239

Specialties & licenses 6

Addresses

Locations

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

{
    "created_epoch": "1627257600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1627257600000",
    "number": "1407529514",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 E 1ST ST STE 302",
            "city": "MOUNT VERNON",
            "state": "NY",
            "postal_code": "105503375",
            "telephone_number": "914-219-4239",
            "fax_number": "914-221-7805"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 E 1ST ST STE 302",
            "city": "MOUNT VERNON",
            "state": "NY",
            "postal_code": "105503375",
            "telephone_number": "914-219-4239",
            "fax_number": "914-221-7805"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE ECHELON SOCIETY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-07-26",
        "last_updated": "2021-07-26",
        "certification_date": "2021-07-26",
        "status": "A",
        "authorized_official_last_name": "FERNANDES",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "PRESIDENT & FOUNDER",
        "authorized_official_telephone_number": "149-219-4239",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "CRPA"
    },
    "taxonomies": [
        {
            "code": "171W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Contractor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "172A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Driver",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "174200000X",
            "taxonomy_group": "",
            "desc": "Meals",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "175T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Peer Specialist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "251V00000X",
            "taxonomy_group": "",
            "desc": "Voluntary or Charitable",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "385H00000X",
            "taxonomy_group": "",
            "desc": "Respite Care",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Peer Specialist in Mount Vernon, NY
• Providers in Mount Vernon, NY by specialty
• Peer Specialist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2021; 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.