Active NPI
Dominique Singletary
- Mental Health Clinic/Center (Including Community Mental Health Center)
- New York, NY
National Provider Identifier
1629859962
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Practice address
- 248 W 108TH St
New York, NY 10025-2956 - Phone
- (212) 663-3001
- Fax
- (646) 383-9216
- NPI assigned
- Oct 12, 2023
- Sex
- Male
- 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 Clinic/Center (Including Community Mental Health Center) | 261QM0801X | Primary |
Addresses
Primary practice location
248 W 108TH St
New York, NY 10025-2956
Mailing address
81 Edwards St
Bridgeport, CT 06606-3004
Phone (908) 764-9148
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1697068800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1697068800000",
"number": "1629859962",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "81 EDWARDS ST",
"city": "BRIDGEPORT",
"state": "CT",
"postal_code": "066063004",
"telephone_number": "908-764-9148"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "248 W 108TH ST",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100252956",
"telephone_number": "212-663-3001",
"fax_number": "646-383-9216"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SINGLETARY",
"first_name": "DOMINIQUE",
"name_prefix": "Mr.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2023-10-12",
"last_updated": "2023-10-12",
"certification_date": "2023-10-12",
"status": "A"
},
"taxonomies": [
{
"code": "261QM0801X",
"taxonomy_group": "",
"desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
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 Oct 12, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.