Isaiah Rapheal Mantooth-Jordan, THERAPIST

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Practice address

225 Old Falls St Ste 3B
Niagara Falls, NY 14303-1262

Phone

(716) 300-8339

NPI assigned

Jul 10, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1531180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1531180800000",
    "number": "1427544766",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "225 OLD FALLS ST STE 3B",
            "city": "NIAGARA FALLS",
            "state": "NY",
            "postal_code": "143031262",
            "telephone_number": "716-300-8339"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "225 OLD FALLS ST STE 3B",
            "city": "NIAGARA FALLS",
            "state": "NY",
            "postal_code": "143031262",
            "telephone_number": "716-300-8339"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANTOOTH-JORDAN",
        "first_name": "ISAIAH",
        "middle_name": "RAPHEAL",
        "credential": "THERAPIST",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-07-10",
        "last_updated": "2018-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• April Elaine Mallard, LPN
• Kati Lynn Mancuso, AGPCNP
• Salvatore John Manente, DDS, MS
• Simmanjeet Mangat, MD
• Elhussien Saber Mansour
• Diamond Daniwes Marcantonio, MSW
• Susan Marie Marcolini, M.S.ED.CCC/SLP
• Ashlie Marcyan
• Alejo R Mariano, DDS
• Donna Maria Mariglio, O.T.

• Mental Health Counselor in Niagara Falls, NY
• Providers in Niagara Falls, NY by specialty
• Mental Health Counselor in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.