Athena Amelia Innes

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

P105689 Issued in NY

Practice address

55 Horizon Dr
Huntington, NY 11743-4436

Phone

(631) 396-2300

NPI assigned

Aug 17, 2020

Last updated

Aug 17, 2020By the provider in NPPES

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

Enrolled in NY

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 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Family Service League, Inc.

  • Community/Behavioral Health Agency
  • Huntington, NY
  • NPI 1528093242
  Medicare reassignment NPD

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

{
    "created_epoch": "1597622400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597622400000",
    "number": "1598377061",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "158 RULAND RD",
            "city": "SELDEN",
            "state": "NY",
            "postal_code": "117841840",
            "telephone_number": "631-681-4953"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 HORIZON DR",
            "city": "HUNTINGTON",
            "state": "NY",
            "postal_code": "117434436",
            "telephone_number": "631-396-2300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "INNES",
        "first_name": "ATHENA",
        "middle_name": "AMELIA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-08-17",
        "last_updated": "2020-08-17",
        "certification_date": "2020-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NY",
            "license": "P105689",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ingredients for Health, PLLC
• Sidney Inkelis, M.D.
• Inner Practice Guidance Counseling LCSW PLLC
• Inner Source Wellness Acupuncture, P.C.
• Innersource Natural Health and Acupuncture, PC (innerSource Health)
• Innovative Otolaryngology, P.C.
• Natalie Rose Insinna
• Integrative Creative Arts Therapy, PLLC
• Integrity Medical Health PLLC
• Anthony M Intintoli, MD

• Mental Health Counselor in Huntington, NY
• Providers in Huntington, 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 Aug 17, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.