Individual provider Active NPI

Mariel Peck

  • Mental Health Counselor
  • Yonkers, NY
National Provider Identifier
1689377301
Registry record updated Mar 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
18-P120774-01 Issued in NY
Practice address
55 Main St
Yonkers, NY 10701-2739
Phone
(646) 612-0920
NPI assigned
Mar 22, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 22, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 18-P120774-01 NY Primary

Addresses

Primary practice location

55 Main St
Yonkers, NY 10701-2739

Mailing address

55 Main St
Yonkers, NY 10701-2739

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT, NY2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20260430000161 CT Practitioner - Mental Health Counselor 3678040318 Reassigns benefits to 1 organization
I20260618002038 NY Practitioner - Mental Health Counselor 3678040318 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2022
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

66 E Flagler St
Miami, FL 33130-1807

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
18-P120774-01NYMDMental Health Counselor

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1679443200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679443200000",
    "number": "1689377301",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 MAIN ST",
            "city": "YONKERS",
            "state": "NY",
            "postal_code": "107012739"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 MAIN ST",
            "city": "YONKERS",
            "state": "NY",
            "postal_code": "107012739",
            "telephone_number": "646-612-0920"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PECK",
        "first_name": "MARIEL",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-03-22",
        "last_updated": "2023-03-22",
        "certification_date": "2023-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NY",
            "license": "18-P120774-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Yonkers, NY

Sources for this page

Verify at the official NPI Registry.