Individual provider Active NPI

Aviva Levitin

  • Mental Health Counselor
  • New Square, NY
National Provider Identifier
1477945475
Registry record updated Dec 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
011582 Issued in NY
Practice address
728 N Main St
New Square, NY 10977-8916
Phone
(845) 354-9300
Fax
(845) 517-1975
NPI assigned
Feb 27, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 26, 2023

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 011582 NY Primary

Addresses

Primary practice location

728 N Main St
New Square, NY 10977-8916

Mailing address

728 N Main St
New Square, NY 10977-8916
Phone (845) 354-9300

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
I20260325003042 NY Practitioner - Mental Health Counselor 8921326257

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Footprints Mental Health Counseling, PC 14 clinicians

Practice addresses (Care Compare)

3249 Kingsbridge Ave
Bronx, NY 10463-5514
Phone (646) 204-2295

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Organizations & group practices 1

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": "1424995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703548800000",
    "number": "1477945475",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "728 N MAIN ST",
            "city": "NEW SQUARE",
            "state": "NY",
            "postal_code": "109778916",
            "telephone_number": "845-354-9300",
            "fax_number": "845-517-1975"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "728 N MAIN ST",
            "city": "NEW SQUARE",
            "state": "NY",
            "postal_code": "109778916",
            "telephone_number": "845-354-9300",
            "fax_number": "845-517-1975"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEVITIN",
        "first_name": "AVIVA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-02-27",
        "last_updated": "2023-12-26",
        "certification_date": "2023-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NY",
            "license": "011582",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Square, NY

Sources for this page

Verify at the official NPI Registry.