Brendaliz Fadul, MHC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

013257-01 Issued in NY

Practice address

19 W 21St St
Suite1003
New York, NY 10010

Phone

(917) 909-6806

NPI assigned

Oct 7, 2021

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Therapy for Mindful Evolution New York LLC

  • Clinic/Center
  • Harriman, NY
  • NPI 1063114379
  NPD Authorized official

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

{
    "created_epoch": "1633564800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690329600000",
    "number": "1508528530",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "41 OXFORD LN",
            "city": "HARRIMAN",
            "state": "NY",
            "postal_code": "109263008",
            "telephone_number": "845-591-8439"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19 W 21ST ST",
            "address_2": "SUITE1003",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "10010",
            "telephone_number": "917-909-6806"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FADUL",
        "first_name": "BRENDALIZ",
        "credential": "MHC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-10-07",
        "last_updated": "2023-07-26",
        "certification_date": "2023-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NY",
            "license": "013257-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Fadeyi Dermatology PLLC
• Darice Williams Fadeyi, M.D.
• Jason Toyin Fadeyi, M.D.
• Fadi F. Attiyeh, M.D., P.C.
• Akintayo Olalekan Fadoju, RN, NP
• Debra Sue Faecher, LCSW
• Gianni L Faedda, MD
• Randy Carol Faerber, L.C.S.W.
• Danielle Faershtein
• Leslie Morrison Faerstein, ED.D.,LCSW

• Mental Health Counselor in New York, NY
• Providers in New York, NY by specialty
• Mental Health Counselor in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.