Carolyn Barravecchio

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

Practice address

35 South Kennedy Drive
Centereach, NY 11720

Phone

(631) 696-0972

NPI assigned

Oct 28, 2019

Last updated

Oct 28, 2019By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Carolyn Glasgow Former name

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

Specialty

Marriage and Family Therapist

Education

Other, 2013

Medicare assignment

May accept Medicare assignment

Telehealth

Offers telehealth services

Group practices

Dynamic Counseling LCSW PCGroup PAC ID 2163839135, 5 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Dynamic Counseling LCSW PC

  • Mental Health Counselor
  • Commack, NY
  • NPI 1457949562
  Medicare reassignment Care Compare group NPD
• Senior Care Therapy LCSW of New York PLLC

  • Clinical Social Worker
  • Flushing, NY
  • NPI 1932677168

  Marriage & Family Therapist

  Medicare reassignment NPD

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

{
    "created_epoch": "1572220800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1572220800000",
    "number": "1508409087",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "35 SOUTH KENNEDY DRIVE",
            "city": "CENTEREACH",
            "state": "NY",
            "postal_code": "11720",
            "telephone_number": "631-696-0972"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "35 SOUTH KENNEDY DRIVE",
            "city": "CENTEREACH",
            "state": "NY",
            "postal_code": "11720",
            "telephone_number": "631-696-0972"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BARRAVECCHIO",
        "first_name": "CAROLYN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-10-28",
        "last_updated": "2019-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CAROLYN",
            "last_name": "GLASGOW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Eva Asamoah, FNP
• Katherine Atatsi
• Ilene Robin Augenlicht, LCSW
• Malak Ishak Azab, PT,DPT
• Wendy Jean Azmoun, MA, CCC-SLP
• Shannon Barresi, LPN
• Danielle Leigh Barrington, DPT
• Dominick Basile, M.D.
• Lauren Marie Bauer
• Gregory Baumgartner

• Marriage & Family Therapist in Centereach, NY
• Providers in Centereach, NY by specialty
• Marriage & Family Therapist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2019; 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.

Verify at the official NPI Registry.