Active NPI
Colombage Asha De Costa, LMHC, ED.M
- Mental Health Counselor
- New York, NY
National Provider Identifier
1629675194
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 0086741-1
- Practice address
- 106 Fort Washington Ave Apt 3K
New York, NY 10032-4723 - Phone
- (917) 406-4015
- NPI assigned
- Oct 7, 2020
- 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 | 0086741-1 | NY | Primary |
Addresses
Primary practice location
106 Fort Washington Ave Apt 3K
New York, NY 10032-4723
Mailing address
106 Fort Washington Ave Apt 3K
New York, NY 10032-4723
Phone (917) 406-4015
Other names 1
- Asha De Costa
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Jan 1, 2024 through Jan 1, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0086741-1 | NY | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1602028800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1604966400000",
"number": "1629675194",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "106 FORT WASHINGTON AVE APT 3K",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100324723",
"telephone_number": "917-406-4015"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "106 FORT WASHINGTON AVE APT 3K",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100324723",
"telephone_number": "917-406-4015"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DE COSTA",
"first_name": "COLOMBAGE",
"middle_name": "ASHA",
"credential": "LMHC, ED.M",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-10-07",
"last_updated": "2020-11-10",
"certification_date": "2020-11-10",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "NY",
"license": "0086741-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "ASHA",
"last_name": "DE COSTA",
"credential": "LMHC, ED.M",
"code": "5",
"type": "Other Name"
}
]
}Other providers in New York, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.