Individual provider Active NPI

Geraldo Jerry Robles III, CRC,LMHC

  • Rehabilitation Counselor
  • Brooklyn, NY
National Provider Identifier
1639336522
Registry record updated Jun 17, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation CounselorTaxonomy code 225C00000X
License
CRC # 00088304 Issued in NY
Practice address
2900 Bedford Ave
Psychology Department
Brooklyn, NY 11210-2850
Phone
(718) 219-8014
NPI assigned
May 19, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 17, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation Counselor 225C00000X CRC # 00088304 NY Primary
Mental Health Counselor 101YM0800X 004380 NY

Addresses

Primary practice location

2900 Bedford Ave
Psychology Department
Brooklyn, NY 11210-2850

Mailing address

2301 Kings Hwy Apt 6H
Brooklyn, NY 11229-1620
Phone (718) 219-8014

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
004380NYMDAcupuncturist
CRC # 00088304NYMDRehabilitation Counselor

NPI Registry JSON

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

{
    "created_epoch": "1211155200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1308268800000",
    "number": "1639336522",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2301 KINGS HWY APT 6H",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112291620",
            "telephone_number": "718-219-8014"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2900 BEDFORD AVE",
            "address_2": "PSYCHOLOGY DEPARTMENT",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112102850",
            "telephone_number": "718-219-8014"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBLES",
        "first_name": "GERALDO",
        "middle_name": "JERRY",
        "name_prefix": "Mr.",
        "name_suffix": "III",
        "credential": "CRC,LMHC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-05-19",
        "last_updated": "2011-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225C00000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Counselor",
            "state": "NY",
            "license": "CRC # 00088304",
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NY",
            "license": "004380",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2011; 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.