Individual provider Active NPI

Christie Marie Brulhardt, MSED, CASAC-T

  • Mental Health Counselor
  • Wantagh, NY
National Provider Identifier
1417469743
Registry record updated Mar 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
013959-01 Issued in NY
Practice address
58 Tinsel CT
Wantagh, NY 11793-1936
Phone
(516) 751-6138
NPI assigned
Oct 26, 2017
Last updated
Mar 3, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 3, 2025

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 013959-01 NY Primary

Addresses

Primary practice location

58 Tinsel CT
Wantagh, NY 11793-1936

Mailing address

58 Tinsel CT
Wantagh, NY 11793-1936
Phone (516) 751-6138

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

State licenses

LicenseStateTypeSpecialty
013959-01NYMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1508976000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740960000000",
    "number": "1417469743",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "58 TINSEL CT",
            "city": "WANTAGH",
            "state": "NY",
            "postal_code": "117931936",
            "telephone_number": "516-751-6138"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "58 TINSEL CT",
            "city": "WANTAGH",
            "state": "NY",
            "postal_code": "117931936",
            "telephone_number": "516-751-6138"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRULHARDT",
        "first_name": "CHRISTIE",
        "middle_name": "MARIE",
        "name_prefix": "Ms.",
        "credential": "MSED, CASAC-T",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-10-26",
        "last_updated": "2025-03-03",
        "certification_date": "2025-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NY",
            "license": "013959-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wantagh, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2025; 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.