Individual provider Active NPI

Brianna Mora, LMHC

  • Mental Health Counselor
  • Commack, NY
National Provider Identifier
1457010308
Registry record updated Sep 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
015118 Issued in NY
Practice address
368 Veterans Memorial Hwy Ste 3
Commack, NY 11725-4322
Phone
(631) 533-0315
NPI assigned
Dec 8, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 13, 2024

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 015118 NY Primary

Addresses

Primary practice location

368 Veterans Memorial Hwy Ste 3
Commack, NY 11725-4322

Mailing address

368 Veterans Memorial Hwy Ste 3
Commack, NY 11725-4322
Phone (631) 533-0315

Other identifiers 1

IdentifierTypeStateIssuer
AR198076OtherCPH AND ASSOCIATES

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
I20250318002824 NY Practitioner - Mental Health Counselor 7618499708 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
015118NYMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Sean Tendler Mental Health Counseling, P.C. Mental Health CurrentSince May 12, 2024 Accepting new patients

Locations

368 Veterans Memorial Hwy
Ste 3
Commack, NY 11725
Phone (631) 533-0315

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1638921600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726185600000",
    "number": "1457010308",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "368 VETERANS MEMORIAL HWY STE 3",
            "city": "COMMACK",
            "state": "NY",
            "postal_code": "117254322",
            "telephone_number": "631-533-0315"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "368 VETERANS MEMORIAL HWY STE 3",
            "city": "COMMACK",
            "state": "NY",
            "postal_code": "117254322",
            "telephone_number": "631-533-0315"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORA",
        "first_name": "BRIANNA",
        "credential": "LMHC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-12-08",
        "last_updated": "2024-09-13",
        "certification_date": "2024-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NY",
            "license": "015118",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CPH AND ASSOCIATES",
            "identifier": "AR198076",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Commack, NY

Sources for this page

Verify at the official NPI Registry.