Kathleen Phillips, MA

Primary specialty

SpecialistTaxonomy code 174400000X

Practice address

225 Broadhollow Rd Ste 402
Melville, NY 11747-4899

Phone

(631) 385-7780

NPI assigned

Dec 13, 2013

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Kathleen J Hennes Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

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

{
    "created_epoch": "1386892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1562803200000",
    "number": "1689095846",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "354 AVENUE A",
            "city": "RONKONKOMA",
            "state": "NY",
            "postal_code": "117791940",
            "telephone_number": "631-816-1106"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "225 BROADHOLLOW RD STE 402",
            "city": "MELVILLE",
            "state": "NY",
            "postal_code": "117474899",
            "telephone_number": "631-385-7780"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "35 Longwood Rd",
            "address_purpose": "LOCATION",
            "city": "Middle Island",
            "state": "NY",
            "postal_code": "119532045",
            "country_code": "US",
            "telephone_number": "631-924-0008",
            "fax_number": "631-924-4602",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PHILLIPS",
        "first_name": "KATHLEEN",
        "credential": "MA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-12-13",
        "last_updated": "2019-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174H00000X",
            "taxonomy_group": "",
            "desc": "Health Educator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATHLEEN",
            "last_name": "HENNES",
            "middle_name": "J",
            "credential": "BA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Kemuel Philippe
• Kristina Philippen
• Paulette Phillippe, LMT
• Autumn Marie Phillips
• Donna Phillips, RN
• Thomas Michael Pica, MSW, LCSW, CASAC 2
• Anna Picarelli
• Ellie Marie Pichardo
• Thomas Edward Picozzi
• Darleng Pierre Louis

• Specialist in Melville, NY
• Providers in Melville, NY by specialty
• Specialist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 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.

Verify at the official NPI Registry.