Individual provider Active NPI

Marilyn Beth Fenty, RN COUNSELOR

  • Mental Health Counselor
  • Dix Hills, NY
National Provider Identifier
1578787222
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
292715 RN Issued in NY
Practice address
31 Melrose Rd
Dix Hills, NY 11746-5610
Phone
(631) 425-1168
Fax
(631) 673-0313
NPI assigned
Apr 12, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 292715 RN NY Primary

Addresses

Primary practice location

31 Melrose Rd
Dix Hills, NY 11746-5610

Mailing address

31 Melrose Rd
Dix Hills, NY 11746-5610
Phone (631) 425-1168

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)
Not enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
292715 RNNYMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Hollow Hills Licensed Clinical Social Work P.C. Current Accepting new patients
Hollow Hills Counseling Center Past Accepting new patients

Organizations & group practices 2

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": "1176336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1578787222",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31 MELROSE RD",
            "city": "DIX HILLS",
            "state": "NY",
            "postal_code": "117465610",
            "telephone_number": "631-425-1168",
            "fax_number": "631-673-0313"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31 MELROSE RD",
            "city": "DIX HILLS",
            "state": "NY",
            "postal_code": "117465610",
            "telephone_number": "631-425-1168",
            "fax_number": "631-673-0313"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FENTY",
        "first_name": "MARILYN",
        "middle_name": "BETH",
        "name_prefix": "Mrs.",
        "credential": "RN COUNSELOR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NY",
            "license": "292715 RN",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dix Hills, NY

Sources for this page

  • 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.