Individual provider Active NPI

Eva Christine Bak, M.S

  • Mental Health Counselor
  • Brooklyn, NY
National Provider Identifier
1417379470
Registry record updated Jan 10, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
102 Pilling Street
Brooklyn, NY 11364
Phone
(718) 602-1000
Fax
(718) 602-1111
NPI assigned
Jan 10, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 10, 2014

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

102 Pilling Street
Brooklyn, NY 11364

Mailing address

102 Pilling Street
Brooklyn, NY 11364
Phone (718) 602-1000

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
Credentials
Master of Science

Practice roles

OrganizationSpecialtyStatusNew patients
Coordinated Behavioral Care Ipa Inc Past Accepting new patients
New York Psychotherapy and Counseling Center PastSince Dec 6, 2010 Accepting new patients

Organizations & group practices 2

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": "1389312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1389312000000",
    "number": "1417379470",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "102 PILLING STREET",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "11364",
            "telephone_number": "718-602-1000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 PILLING STREET",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "11364",
            "telephone_number": "718-602-1000",
            "fax_number": "718-602-1111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAK",
        "first_name": "EVA",
        "middle_name": "CHRISTINE",
        "credential": "M.S",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-01-10",
        "last_updated": "2014-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2014; 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.