Individual provider Active NPI

Christina A. Menichello, NCC

  • Mental Health Counselor
  • Owego, NY
National Provider Identifier
1437296589
Registry record updated Oct 1, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
207663 Issued in NY
Practice address
1062 State Route 38
Owego, NY 13827
Phone
(607) 687-4000
Fax
(607) 687-6396
NPI assigned
Jan 30, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 1, 2007

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 207663 NY Primary

Addresses

Primary practice location

1062 State Route 38
Owego, NY 13827

Mailing address

1062 State Route 38
PO Box 177
Owego, NY 13827-3209
Phone (607) 687-4000

Other identifiers 2

IdentifierTypeStateIssuer
207663OtherNCC CERTIFICATE NUMBER
00618162MedicaidNY

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
207663NYMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1170115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1191196800000",
    "number": "1437296589",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1062 STATE ROUTE 38",
            "address_2": "PO BOX 177",
            "city": "OWEGO",
            "state": "NY",
            "postal_code": "138273209",
            "telephone_number": "607-687-4000",
            "fax_number": "607-687-6396"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1062 STATE ROUTE 38",
            "city": "OWEGO",
            "state": "NY",
            "postal_code": "13827",
            "telephone_number": "607-687-4000",
            "fax_number": "607-687-6396"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MENICHELLO",
        "first_name": "CHRISTINA",
        "middle_name": "A.",
        "credential": "NCC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-30",
        "last_updated": "2007-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NY",
            "license": "207663",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCC CERTIFICATE NUMBER",
            "identifier": "207663",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00618162",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Owego, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2007; 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.