Active NPI
Joan Desmond
- Addiction (Substance Use Disorder) Counselor
- Freeport, NY
National Provider Identifier
1619408747
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- License
- 2909
- Practice address
- 333 N Main St
Freeport, NY 11520-1231 - Phone
- (516) 634-0012
- NPI assigned
- Mar 21, 2017
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 2909 | NY | Primary |
Addresses
Primary practice location
333 N Main St
Freeport, NY 11520-1231
Mailing address
265 Edgewater Ave
Bayport, NY 11705-2103
Phone (631) 885-0951
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2909 | Other | NY | CASAC CERTIFICATE |
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 |
|---|---|---|---|
| 2909 | NY | MD | Prosthetist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1490054400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1490054400000",
"number": "1619408747",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "265 EDGEWATER AVE",
"city": "BAYPORT",
"state": "NY",
"postal_code": "117052103",
"telephone_number": "631-885-0951"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "333 N MAIN ST",
"city": "FREEPORT",
"state": "NY",
"postal_code": "115201231",
"telephone_number": "516-634-0012"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DESMOND",
"first_name": "JOAN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-03-21",
"last_updated": "2017-03-21",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "NY",
"license": "2909",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CASAC CERTIFICATE",
"identifier": "2909",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Freeport, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.