Individual provider Active NPI

Esthella Chambo

  • Addiction (Substance Use Disorder) Counselor
  • New York, NY
National Provider Identifier
1689046641
Registry record updated Oct 29, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
Practice address
73 Lenox Ave
New York, NY 10026-3007
Phone
(212) 663-1596
NPI assigned
Oct 29, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 29, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X Primary

Addresses

Primary practice location

73 Lenox Ave
New York, NY 10026-3007

Mailing address

73 Lenox Ave
New York, NY 10026-3007
Phone (212) 663-1596

Other identifiers 1

IdentifierTypeStateIssuer
132739938MedicaidNY

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": "1446076800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1446076800000",
    "number": "1689046641",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "73 LENOX AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100263007",
            "telephone_number": "212-663-1596"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "73 LENOX AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100263007",
            "telephone_number": "212-663-1596"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAMBO",
        "first_name": "ESTHELLA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-10-29",
        "last_updated": "2015-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "132739938",
            "state": "NY"
        }
    ],
    "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 29, 2015; 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.