Debra Joan Kingsley, MENTAL HEALTH COUNSE

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

003628 Issued in NY

Practice address

646 Main St
Port Jefferson, NY 11777-2235

Phone

(631) 365-9839

NPI assigned

Jan 16, 2007

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

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

{
    "created_epoch": "1168905600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1528119294",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7 HILLTOP DR",
            "city": "MOUNT SINAI",
            "state": "NY",
            "postal_code": "117661714",
            "telephone_number": "631-473-7366"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "646 MAIN ST",
            "city": "PORT JEFFERSON",
            "state": "NY",
            "postal_code": "117772235",
            "telephone_number": "631-365-9839"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KINGSLEY",
        "first_name": "DEBRA",
        "middle_name": "JOAN",
        "name_prefix": "Mrs.",
        "credential": "MENTAL HEALTH COUNSE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NY",
            "license": "003628",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kim Tassinari Mental Health Counseling, PLLC
• Christopher Kim, DO
• Joseph Kiho Kim, MD
• Misook Kim
• Ted Ilhyun Kim
• Gary John Kingsley, PH.D.
• Linda Karen Kirk, LCSW
• Rebecca C Kirschner, CCC
• KK NP in Adult Health LLP
• Robert Klare, PT, CHT

• Mental Health Counselor in Port Jefferson, NY
• Providers in Port Jefferson, 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 8, 2007; 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.