Samantha Desiderio, LMHC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

012317 Issued in NY

Practice address

3285B Richmond Ave Ste 200
Staten Island, NY 10312-2123

Phone

(347) 238-8986

NPI assigned

Feb 17, 2023

Last updated

Feb 27, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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

• Journey of the Mind Mental Health Counseling PLLC

  • Mental Health Counselor
  • Staten Island, NY
  • NPI 1326746462
  NPD Authorized official

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

{
    "created_epoch": "1676592000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677456000000",
    "number": "1700584836",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3285B RICHMOND AVE STE 200",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103122123",
            "telephone_number": "347-671-7038"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3285B RICHMOND AVE STE 200",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103122123",
            "telephone_number": "347-238-8986"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DESIDERIO",
        "first_name": "SAMANTHA",
        "credential": "LMHC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-02-17",
        "last_updated": "2023-02-27",
        "certification_date": "2023-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NY",
            "license": "012317",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "012317-01",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Joseph Desena, MD
• Lorrie Desena
• Salvatore Desena, MD
• Nicolette Deserio
• Jose Antonio Desiderio, LMHC
• Michele Desimone, M.A., CCC-SLP
• Benjamin Desir
• Maykel Desir
• Antonio G Desposito, DC
• Hilde Emmaline Dessalines

• Mental Health Counselor in Staten Island, NY
• Providers in Staten Island, NY by specialty
• Mental Health Counselor in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2023; 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.