Fred Doulton
Individual provider Active NPI Mental Health Counselor · Glen Head, NY
NPI 1639754138 · NPPES record last updated Mar 16, 2021
Key facts
- NPI
- 1639754138
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Mental Health Counselor 101YM0800X
- License
- 011164 (NY)
- Practice address
- 102 Glen Cove Dr
Glen Head, NY 11545-1715 - Phone
- (516) 551-5493
- NPI assigned
- Mar 16, 2021
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 011164 | NY | Yes |
Addresses
Primary practice location
102 Glen Cove Dr
Glen Head, NY 11545-1715
Mailing address
102 Glen Cove Dr
Glen Head, NY 11545-1715
Phone (516) 551-5493
Other practice location 1
110 Main St
Mineola, NY 11501-4000
Phone (516) 747-5644 ext. 1628
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | fdoulton@seafieldcenter.com | Direct | Seafield Services, Inc. |
Other providers in Glen Head, NY
- Joseph D'Antonio Jr.
- Nicole J D'Aversa
- Linda A Darby
- Garry Richard Dbrant
- Alison Diaz-Perez
- Cynthia Ann Downing
- Dr John Kelly Anesthesia PC
- Dr.Roy F.Gherardi
- Susan A Dubourg
- Ear Nose & Throat Medical Services of New York, PLLC
All providers in Glen Head, NY · Mental Health Counselor in New York
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 16, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.