Active NPI
Paroda Loy Decavallas, LMHC
- Mental Health Counselor
- Latham, NY
National Provider Identifier
1669017091
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 006377-1
- Practice address
- 19 Comely LN
Latham, NY 12110-5225 - Phone
- (518) 598-3834
- NPI assigned
- Nov 8, 2019
- Sex
- Female
- Sole proprietor
- No
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 | 006377-1 | NY | Primary |
Addresses
Primary practice location
19 Comely LN
Latham, NY 12110-5225
Mailing address
19 Comely LN
Latham, NY 12110-5225
Phone (518) 598-3834
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 006377-1 | Other | NY | UNIVERSITY OF THE STATE OF NEW YORK EDUCATION DEPARTMENT OFFICE OF PROFESSIONS |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 006377-1 | NY | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1573171200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1573171200000",
"number": "1669017091",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "19 COMELY LN",
"city": "LATHAM",
"state": "NY",
"postal_code": "121105225",
"telephone_number": "518-598-3834"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "19 COMELY LN",
"city": "LATHAM",
"state": "NY",
"postal_code": "121105225",
"telephone_number": "518-598-3834"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DECAVALLAS",
"first_name": "PARODA",
"middle_name": "LOY",
"credential": "LMHC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-11-08",
"last_updated": "2019-11-08",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "NY",
"license": "006377-1",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNIVERSITY OF THE STATE OF NEW YORK EDUCATION DEPARTMENT OFFICE OF PROFESSIONS",
"identifier": "006377-1",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Latham, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.