Active NPI
Tami Mallet - Edwards
- Peer Specialist
- Poughkeepsie, NY
National Provider Identifier
1619685567
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Peer Specialist
- License
- 4912
- Practice address
- 102 Fulton Ave
Poughkeepsie, NY 12603-2857 - Phone
- (845) 452-2728
- NPI assigned
- Nov 9, 2022
- 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 |
|---|---|---|---|---|
| Peer Specialist | 175T00000X | 4912 | NY | Primary |
Addresses
Primary practice location
102 Fulton Ave
Poughkeepsie, NY 12603-2857
Mailing address
102 Fulton Ave
Poughkeepsie, NY 12603-2857
Phone (845) 452-2728
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | drosemberg@people-usa.org |
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 |
|---|---|---|---|
| 4912 | NY | MD | Addiction (Substance Use Disorder) Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1667952000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1667952000000",
"number": "1619685567",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "102 FULTON AVE",
"city": "POUGHKEEPSIE",
"state": "NY",
"postal_code": "126032857",
"telephone_number": "845-452-2728"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "102 FULTON AVE",
"city": "POUGHKEEPSIE",
"state": "NY",
"postal_code": "126032857",
"telephone_number": "845-452-2728"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MALLET - EDWARDS",
"first_name": "TAMI",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-11-09",
"last_updated": "2022-11-09",
"certification_date": "2022-11-09",
"status": "A"
},
"taxonomies": [
{
"code": "175T00000X",
"taxonomy_group": "",
"desc": "Peer Specialist",
"state": "NY",
"license": "4912",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "drosemberg@people-usa.org",
"affiliation": "N",
"endpointDescription": "Company's Email Address",
"address_1": "102 Fulton Ave",
"city": "Poughkeepsie",
"state": "NY",
"country_code": "US",
"postal_code": "126032857",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Poughkeepsie, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.