NPIMap

Individual provider Active NPI

Kanakamalar Mahadavan

  • Addiction (Substance Use Disorder) Counselor
  • White Plains, NY
National Provider Identifier
1629443346
Registry record updated Dec 7, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
23211 Issued in NY
Practice address
20 Church St
2ND Floor
White Plains, NY 10601-1901
Phone
(914) 421-0400
Fax
(914) 421-0401
NPI assigned
Dec 7, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 7, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 23211 NY Primary

Addresses

Primary practice location

20 Church St
2ND Floor
White Plains, NY 10601-1901

Mailing address

20 Church St
2ND Floor
White Plains, NY 10601-1901
Phone (914) 421-0400

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

LicenseStateTypeSpecialty
23211NYMDAddiction (Substance Use Disorder) Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Sancia Wellness Inc. Past Accepting new patients
Sancia Health Care, Inc. Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1449446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1449446400000",
    "number": "1629443346",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 CHURCH ST",
            "address_2": "2ND FLOOR",
            "city": "WHITE PLAINS",
            "state": "NY",
            "postal_code": "106011901",
            "telephone_number": "914-421-0400",
            "fax_number": "914-421-0401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 CHURCH ST",
            "address_2": "2ND FLOOR",
            "city": "WHITE PLAINS",
            "state": "NY",
            "postal_code": "106011901",
            "telephone_number": "914-421-0400",
            "fax_number": "914-421-0401"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAHADAVAN",
        "first_name": "KANAKAMALAR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-12-07",
        "last_updated": "2015-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NY",
            "license": "23211",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in White Plains, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 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.

Verify at the official NPI Registry.