Individual provider Active NPI

Angelina Acevedo

  • Mental Health Counselor
  • Bronx, NY
National Provider Identifier
1447837836
Registry record updated Jun 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
579 Courtlandt Ave
Bronx, NY 10451-5013
Phone
(718) 485-2100
NPI assigned
Mar 24, 2021
Last updated
Jun 15, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 15, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X NU Primary
Student in an Organized Health Care Education/Training Program 390200000X NU

Addresses

Primary practice location

579 Courtlandt Ave
Bronx, NY 10451-5013

Mailing address

701 W 175TH St Apt 3C
New York, NY 10033-7612

Other identifiers 1

IdentifierTypeStateIssuer
472196599OtherNYDRIVER LICENSE

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
I20241112001983 NY Practitioner - Mental Health Counselor 9638603707 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2022
Medicare assignment
May accept Medicare assignment
Group practices
New York Psychotherapy and Counseling CenterGroup PAC ID 4880600147, 113 clinicians

Practice addresses (Care Compare)

579 Courtlandt Ave
Bronx, NY 10451-5013
Phone (718) 485-2100

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
New York Psychotherapy and Counseling Center CurrentSince Sep 6, 2024 Accepting new patients
Coordinated Behavioral Care Ipa Inc PastSince Mar 28, 2021 Accepting new patients

Locations

579 Courtlandt Ave
Bronx, NY 10451
Phone (718) 908-8000

2857 Linden Blvd
Brooklyn, NY 11208
Phone (718) 235-3100

17620 148th Ave
Jamaica, NY 11434
Phone (718) 553-1100

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1616544000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655251200000",
    "number": "1447837836",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "701 W 175TH ST APT 3C",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100337612"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "579 COURTLANDT AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104515013",
            "telephone_number": "718-485-2100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ACEVEDO",
        "first_name": "ANGELINA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-03-24",
        "last_updated": "2022-06-15",
        "certification_date": "2022-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DRIVER LICENSE",
            "identifier": "472196599",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

Verify at the official NPI Registry.