Pleasantville Wellness LLC

Primary specialty

CounselorTaxonomy code 101Y00000X

Legal business name

PLEASANTVILLE WELLNESS LLC

Doing business as

Pleasantville Wellness Group

Practice address

57 Wheeler Ave Ste 208
Pleasantville, NY 10570-3038

Phone

(917) 512-8557

NPI assigned

Dec 2, 2021

Organization subpart

No

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

Authorized official

Name

Kelly Keck, LMHCNPI 1831529387

Title

Owner

Phone

(914) 943-9672

Specialties & licenses 1

Addresses

Other names 1

• Pleasantville Wellness Group Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Kelly Keck, LMHC

  • Mental Health Counselor
  • Pleasantville, NY
  • NPI 1831529387
  NPD Authorized official

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

{
    "created_epoch": "1638403200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1638403200000",
    "number": "1578221966",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "57 WHEELER AVE STE 208",
            "city": "PLEASANTVILLE",
            "state": "NY",
            "postal_code": "105703038",
            "telephone_number": "917-512-8557"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "57 WHEELER AVE STE 208",
            "city": "PLEASANTVILLE",
            "state": "NY",
            "postal_code": "105703038",
            "telephone_number": "917-512-8557"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PLEASANTVILLE WELLNESS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-12-02",
        "last_updated": "2021-12-02",
        "certification_date": "2021-12-02",
        "status": "A",
        "authorized_official_last_name": "KECK",
        "authorized_official_first_name": "KELLY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "914-943-9672",
        "authorized_official_credential": "LMHC"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pleasantville Wellness Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2021; 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.