Active NPI
Yoshimi Shimizu
- Mental Health Counselor
- New York, NY
National Provider Identifier
1437633195
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 011728
- Practice address
- 225 Broadway # 1570
New York, NY 10007-3001 - Phone
- (201) 474-2044
- NPI assigned
- Sep 19, 2018
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | P12756 | NY | |
| Mental Health Counselor | 101YM0800X | 011728 | NY | Primary |
Addresses
Primary practice location
225 Broadway # 1570
New York, NY 10007-3001
Mailing address
225 Broadway # 1570
New York, NY 10007-3001
Phone (201) 470-7685
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Jan 1, 2024 through Jan 1, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 011728 | NY | MD | Mental Health Counselor |
| P12756 | NY | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1537315200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1668988800000",
"number": "1437633195",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "225 BROADWAY # 1570",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100073001",
"telephone_number": "201-470-7685"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "225 BROADWAY # 1570",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100073001",
"telephone_number": "201-474-2044"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHIMIZU",
"first_name": "YOSHIMI",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-09-19",
"last_updated": "2022-11-21",
"certification_date": "2022-11-21",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Counselor, Mental Health",
"state": "NY",
"license": "P12756",
"primary": false
},
{
"code": "101YM0800X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Counselor, Mental Health",
"state": "NY",
"license": "011728",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in New York, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.