Active NPI
Maryellen Adams
- Mental Health Counselor
- East Islip, NY
National Provider Identifier
1487237301
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- Practice address
- 107 W Main St
East Islip, NY 11730-2337 - Phone
- (631) 666-1615
- Fax
- (631) 666-1709
- NPI assigned
- Apr 29, 2021
- 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 | 011181-01 | NY | |
| Mental Health Counselor | 101YM0800X | Primary |
Addresses
Primary practice location
107 W Main St
East Islip, NY 11730-2337
Mailing address
211 Academy St
Bayport, NY 11705-1827
Phone (631) 327-9551
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Mental Health Counselor
- Education
- Other, 2009
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
107 W Main St
East Islip, NY 11730-2337
Phone (631) 666-1615
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 011181-01 | NY | MD | Mental Health Counselor |
| 011181 | NY | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sunrise Counseling Center,LTD | Single Specialty | Current | Accepting new patients |
Locations
107 W Main St
East Islip, NY 11730
Phone (631) 666-1615
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": "1619654400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1619654400000",
"number": "1487237301",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "211 ACADEMY ST",
"city": "BAYPORT",
"state": "NY",
"postal_code": "117051827",
"telephone_number": "631-327-9551"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "107 W MAIN ST",
"city": "EAST ISLIP",
"state": "NY",
"postal_code": "117302337",
"telephone_number": "631-666-1615",
"fax_number": "631-666-1709"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ADAMS",
"first_name": "MARYELLEN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-04-29",
"last_updated": "2021-04-29",
"certification_date": "2021-04-28",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "NY",
"license": "011181-01",
"primary": false
},
{
"code": "101YM0800X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Counselor, Mental Health",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in East Islip, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.