Individual provider Active NPI

Gladys Pietri-McCormack, LCSW

  • Mental Health Counselor
  • Staten Island, NY
National Provider Identifier
1548404650
Registry record updated May 3, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
046207-1 Issued in NY
Practice address
269 Kell Ave
Staten Island, NY 10314-4113
Phone
(718) 494-2526
NPI assigned
Apr 21, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 3, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 046207-1 NY Primary
School Counselor 101YS0200X 046207-1 NY

Addresses

Primary practice location

269 Kell Ave
Staten Island, NY 10314-4113

Mailing address

269 Kell Ave
Staten Island, NY 10314-4113
Phone (718) 494-2526

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
046207-1NYMDSchool Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
The New York and Presbyterian Hospital Past Accepting new patients

Interoperability endpoints

  • FHIR API: https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/R4/
  • FHIR API: https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/DSTU2/

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": "1240272000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1336003200000",
    "number": "1548404650",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "269 KELL AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103144113",
            "telephone_number": "718-494-2526"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "269 KELL AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103144113",
            "telephone_number": "718-494-2526"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PIETRI-MCCORMACK",
        "first_name": "GLADYS",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-04-21",
        "last_updated": "2012-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NY",
            "license": "046207-1",
            "primary": true
        },
        {
            "code": "101YS0200X",
            "taxonomy_group": "",
            "desc": "Counselor, School",
            "state": "NY",
            "license": "046207-1",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Staten Island, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2012; 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.