Individual provider Active NPI

Kathleen Thelian, PMH-NP

  • Psychiatric/Mental Health Nurse Practitioner
  • Garden City, NY
National Provider Identifier
1437540754
Registry record updated Feb 9, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
F400264-1 Issued in NY
Practice address
176 Nassau Blvd
Garden City, NY 11530-5553
Phone
(516) 741-1798
NPI assigned
Feb 9, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 9, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X F400264-1 NY Primary

Addresses

Primary practice location

176 Nassau Blvd
Garden City, NY 11530-5553

Mailing address

176 Nassau Blvd
Garden City, NY 11530-5553
Phone (516) 741-1798

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
F400264-1NYMDPsychiatric/Mental Health Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1423440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1423440000000",
    "number": "1437540754",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "176 NASSAU BLVD",
            "city": "GARDEN CITY",
            "state": "NY",
            "postal_code": "115305553",
            "telephone_number": "516-741-1798"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "176 NASSAU BLVD",
            "city": "GARDEN CITY",
            "state": "NY",
            "postal_code": "115305553",
            "telephone_number": "516-741-1798"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THELIAN",
        "first_name": "KATHLEEN",
        "credential": "PMH-NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-02-09",
        "last_updated": "2015-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NY",
            "license": "F400264-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Garden City, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2015; 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.