Active NPI
Snathalia Supreme
- Mental Health Counselor
- New City, NY
National Provider Identifier
1427626209
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 014410
- Practice address
- 77 S Main St
New City, NY 10956-3511 - Phone
- (845) 634-5729
- NPI assigned
- Jun 16, 2021
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 014410 | NY | Primary |
Addresses
Primary practice location
77 S Main St
New City, NY 10956-3511
Mailing address
21 Lillian St
Pomona, NY 10970-2626
Phone (845) 367-1659
Medicare participation
Medicare enrollment files- 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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Mental Health Counselor
- Education
- Mercy College, 2021
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
109 W 27TH St
5S
New York, NY 10001-6208
Phone (833) 351-8255
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 014410 | NY | MD | Mental Health Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| VCS Inc. | Current | Accepting new patients |
Locations
77 S Main St
New City, NY 10956
Phone (845) 634-5729
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.
-
- Community/Behavioral Health Agency
- New City, NY
- NPI 1053617035
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1623801600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1710288000000",
"number": "1427626209",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "21 LILLIAN ST",
"city": "POMONA",
"state": "NY",
"postal_code": "109702626",
"telephone_number": "845-367-1659"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "77 S MAIN ST",
"city": "NEW CITY",
"state": "NY",
"postal_code": "109563511",
"telephone_number": "845-634-5729"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SUPREME",
"first_name": "SNATHALIA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-06-16",
"last_updated": "2024-03-13",
"certification_date": "2024-03-13",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "NY",
"license": "014410",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in New City, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2024; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.