Individual provider Active NPI

Jessica Vallario, LMHC

  • Mental Health Counselor
  • Dix Hills, NY
National Provider Identifier
1629613781
Registry record updated Nov 13, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
009709 Issued in NY
Practice address
465 Wolf Hill Rd
Dix Hills, NY 11746-5722
Phone
(631) 466-7163
NPI assigned
Nov 13, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 13, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 009709 NY Primary

Addresses

Primary practice location

465 Wolf Hill Rd
Dix Hills, NY 11746-5722

Mailing address

465 Wolf Hill Rd
Dix Hills, NY 11746-5722
Phone (631) 466-7163

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240130003062 NY Practitioner - Mental Health Counselor 2769835313 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Sunrise Counseling Center,LTD CurrentSince Jan 17, 2024 Accepting new patients

Locations

107 W Main St
East Islip, NY 11730
Phone (631) 666-1615

Organizations & group practices 1

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": "1573603200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1573603200000",
    "number": "1629613781",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "465 WOLF HILL RD",
            "city": "DIX HILLS",
            "state": "NY",
            "postal_code": "117465722",
            "telephone_number": "631-466-7163"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "465 WOLF HILL RD",
            "city": "DIX HILLS",
            "state": "NY",
            "postal_code": "117465722",
            "telephone_number": "631-466-7163"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VALLARIO",
        "first_name": "JESSICA",
        "credential": "LMHC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-11-13",
        "last_updated": "2019-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NY",
            "license": "009709",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dix Hills, NY

Sources for this page

Verify at the official NPI Registry.