Individual provider Active NPI

Iryna Shemelyuk, LMHC

  • Counselor
  • Rego Park, NY
National Provider Identifier
1619163672
Registry record updated May 1, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
License
002670 Issued in NY
Practice address
9701 66TH Ave
Rego Park, NY 11374-4245
Phone
(917) 400-8354
NPI assigned
Sep 23, 2007
Last updated
May 1, 2020By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 1, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X 002670 NY Primary
Marriage & Family Therapist 106H00000X 000471 NY

Addresses

Primary practice location

9701 66TH Ave
Rego Park, NY 11374-4245

Mailing address

7410 35TH Ave
Apt.114W
Jackson Heights, NY 11372-8160
Phone (917) 400-8354

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20240213001500 NY Practitioner - Mental Health Counselor 9739522178 Practice locations: Rego Park, NY

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

9701 66TH Ave
Rego Park, NY 11374-4245
Phone (917) 400-8354

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
000471NYMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Luc Services Inc. Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1190505600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1588291200000",
    "number": "1619163672",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7410 35TH AVE",
            "address_2": "APT.114W",
            "city": "JACKSON HEIGHTS",
            "state": "NY",
            "postal_code": "113728160",
            "telephone_number": "917-400-8354",
            "fax_number": "718-967-3619"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9701 66TH AVE",
            "city": "REGO PARK",
            "state": "NY",
            "postal_code": "113744245",
            "telephone_number": "917-400-8354"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHEMELYUK",
        "first_name": "IRYNA",
        "name_prefix": "Mrs.",
        "credential": "LMHC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-09-23",
        "last_updated": "2020-05-01",
        "certification_date": "2020-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "NY",
            "license": "002670",
            "primary": true
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "NY",
            "license": "000471",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rego Park, NY

Sources for this page

Verify at the official NPI Registry.