Active NPI
Johanna Mary Gersten, LMHC
- Mental Health Counselor
- Monticello, NY
National Provider Identifier
1629256805
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 003410
- Practice address
- 390 Broadway
Monticello, NY 12701-1157 - Phone
- (914) 799-2121
- NPI assigned
- Feb 10, 2008
- 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 | 003410 | NY | Primary |
Addresses
Primary practice location
390 Broadway
Monticello, NY 12701-1157
Mailing address
186 Dillon Rd
Monticello, NY 12701-1658
Phone (914) 799-2121
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 590215 | Other | NY | VALUEOPTIONS |
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 |
|---|---|---|---|
| 003410 | NY | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1202601600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1273104000000",
"number": "1629256805",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "186 DILLON RD",
"city": "MONTICELLO",
"state": "NY",
"postal_code": "127011658",
"telephone_number": "914-799-2121"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "390 BROADWAY",
"city": "MONTICELLO",
"state": "NY",
"postal_code": "127011157",
"telephone_number": "914-799-2121"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GERSTEN",
"first_name": "JOHANNA",
"middle_name": "MARY",
"name_prefix": "Ms.",
"credential": "LMHC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-02-10",
"last_updated": "2010-05-06",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "NY",
"license": "003410",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "VALUEOPTIONS",
"identifier": "590215",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Monticello, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.