Active NPI
Brenda Bennett
- Mental Health Counselor
- Brooklyn, NY
National Provider Identifier
1609138288
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 086117-1
- Practice address
- 1623 Kings Hwy
Brooklyn, NY 11229-1209 - Phone
- (718) 375-1200
- Fax
- (718) 382-3358
- NPI assigned
- Jun 11, 2012
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 086117-1 | NY | Primary |
Addresses
Primary practice location
1623 Kings Hwy
Brooklyn, NY 11229-1209
Mailing address
1623 Kings Hwy
Brooklyn, NY 11229-1209
Phone (718) 375-1200
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 237358415 | Medicaid | NY |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 086117-1 | NY | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1339372800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1339372800000",
"number": "1609138288",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1623 KINGS HWY",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112291209",
"telephone_number": "718-375-1200",
"fax_number": "718-382-3358"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1623 KINGS HWY",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112291209",
"telephone_number": "718-375-1200",
"fax_number": "718-382-3358"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BENNETT",
"first_name": "BRENDA",
"name_prefix": "Mrs.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2012-06-11",
"last_updated": "2012-06-11",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "NY",
"license": "086117-1",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "237358415",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Brooklyn, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 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.