Individual provider Active NPI

Jacqueline Paul

  • Mental Health Counselor
  • New York, NY
National Provider Identifier
1548622103
Registry record updated Mar 23, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
73 Lenox Ave
New York, NY 10026-3007
Phone
(212) 663-1596
Fax
(212) 663-1323
NPI assigned
Mar 23, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 23, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X Primary

Addresses

Primary practice location

73 Lenox Ave
New York, NY 10026-3007

Mailing address

2121 Madison Ave Apt 2D
New York, NY 10037-2817
Phone (212) 663-1596

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ, NY2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20260514000573 NJ Practitioner - Mental Health Counselor 2264901776 Reassigns benefits to 2 organizations
I20260613000219 NY Practitioner - Mental Health Counselor 2264901776 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2015
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

200 United States Ave E
Gibbsboro, NJ 08026-1112

648 Newark Ave
Elizabeth, NJ 07208-3539

66 E Flagler St
Miami, FL 33130-1807

857 Hoes LN W
Scarlet 2
Piscataway, NJ 08854-5651

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Organizations & group practices 3

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": "1458691200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1458691200000",
    "number": "1548622103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2121 MADISON AVE APT 2D",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100372817",
            "telephone_number": "212-663-1596",
            "fax_number": "212-663-1323"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "73 LENOX AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100263007",
            "telephone_number": "212-663-1596",
            "fax_number": "212-663-1323"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAUL",
        "first_name": "JACQUELINE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-03-23",
        "last_updated": "2016-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.