Active NPI
Russell Roten, MA, RDT, LCAT
- Mental Health Counselor
- Astoria, NY
National Provider Identifier
1619351509
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 05001445
- Practice address
- 421 27TH Ave
Astoria, NY 11102-4175 - Phone
- (718) 361-7030
- NPI assigned
- Jul 10, 2015
- Sex
- Male
- Sole proprietor
- No
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 | 05001445 | NY | Primary |
Addresses
Primary practice location
421 27TH Ave
Astoria, NY 11102-4175
Mailing address
421 27TH Ave
Astoria, NY 11102-4175
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
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 05001445 | NY | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1436486400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1436486400000",
"number": "1619351509",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "421 27TH AVE",
"city": "ASTORIA",
"state": "NY",
"postal_code": "111024175"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "421 27TH AVE",
"city": "ASTORIA",
"state": "NY",
"postal_code": "111024175",
"telephone_number": "718-361-7030"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROTEN",
"first_name": "RUSSELL",
"credential": "MA, RDT, LCAT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2015-07-10",
"last_updated": "2015-07-10",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "NY",
"license": "05001445",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Astoria, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.