Individual provider Active NPI

Charlee Degeorge

  • Counselor
  • Kingston, NY
National Provider Identifier
1447724356
Registry record updated Jan 14, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
Practice address
139 Cornell St
Kingston, NY 12401-3633
Phone
(845) 338-1234
NPI assigned
Jan 14, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 14, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X Primary

Addresses

Primary practice location

139 Cornell St
Kingston, NY 12401-3633

Mailing address

55 Nevis Rd
Tivoli, NY 12583-5010

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240318003133 NY Practitioner - Mental Health Counselor 2567809239 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
East Rockaway Neuropsychology, PC CurrentSince Jan 6, 2024 Accepting new patients
Hudson Valley Health Specialties, Inc Past Accepting new patients
Nysarc Inc. Ulster, Greene, Putnam Counties Chapter PastSince Oct 12, 2015 Accepting new patients

Locations

100 Merrick Rd
Ste 510
Rockville Ctr, NY 11570
Phone (516) 341-6215

100 Merrick Rd
Ofc 510E
Rockville Ctr, NY 11570

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1547424000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1547424000000",
    "number": "1447724356",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 NEVIS RD",
            "city": "TIVOLI",
            "state": "NY",
            "postal_code": "125835010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "139 CORNELL ST",
            "city": "KINGSTON",
            "state": "NY",
            "postal_code": "124013633",
            "telephone_number": "845-338-1234"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEGEORGE",
        "first_name": "CHARLEE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-01-14",
        "last_updated": "2019-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kingston, NY

Sources for this page

Verify at the official NPI Registry.