Jean-Ralph Petido, LMHC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

014622 Issued in NY

Practice address

2 Wilson PL FL 2
Mount Vernon, NY 10550-2602

Phone

(914) 668-9124

Fax

(914) 668-0940

NPI assigned

Apr 22, 2024

Sex

Male

Sole proprietor

No

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

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

Mental Health Counselor

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Beacon Place LLCGroup PAC ID 3577866839, 7 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 and National Provider Directory roles.

• Beacon Place LLC

  • Adult Day Care Clinic/Center
  • Highland Mills, NY
  • NPI 1326429630
  Medicare reassignment Care Compare group NPD
• Che Senior Psychological Services, PC

  • Clinical Psychologist
  • Brooklyn, NY
  • NPI 1023078219
  Medicare reassignment NPD
• Knapp Street Psychiatry, PC

  • Clinical Psychologist
  • Brooklyn, NY
  • NPI 1043248776
  Medicare reassignment NPD

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

{
    "created_epoch": "1713744000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714608000000",
    "number": "1508611625",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "43 UNDERHILL RD APT 4",
            "city": "MIDDLETOWN",
            "state": "NY",
            "postal_code": "109409445",
            "telephone_number": "845-480-4131"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 WILSON PL FL 2",
            "city": "MOUNT VERNON",
            "state": "NY",
            "postal_code": "105502602",
            "telephone_number": "914-668-9124",
            "fax_number": "914-668-0940"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETIDO",
        "first_name": "JEAN-RALPH",
        "credential": "LMHC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-04-22",
        "last_updated": "2024-05-02",
        "certification_date": "2024-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NY",
            "license": "014622",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shakara Simone Perez, M.S.ED
• Stephanie Pernas
• Alexis Persaud
• Alan Peschiera, RPH
• Carrie Colleen Peters Smith, PTA
• Carol Petretti, LMSW
• Adelina Petrielloarenas, OSC
• Richard Louis Petrillo, MD
• Philip Pharmacy Solution LLC
• Kalisha V Phillip

• Mental Health Counselor in Mount Vernon, NY
• Providers in Mount Vernon, 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 May 2, 2024; 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.