Crista Lin Simonetti, LCSW-R

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

073728 Issued in NY

Practice address

269 W Main St
Bay Shore, NY 11706-8319

Phone

(631) 885-5830

NPI assigned

Aug 25, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Mrs. Crista Lin Simonetti Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1156464000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1356048000000",
    "number": "1710095492",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "269 W MAIN ST",
            "city": "BAY SHORE",
            "state": "NY",
            "postal_code": "117068319",
            "telephone_number": "631-885-5830"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "269 W MAIN ST",
            "city": "BAY SHORE",
            "state": "NY",
            "postal_code": "117068319",
            "telephone_number": "631-885-5830"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMONETTI",
        "first_name": "CRISTA",
        "middle_name": "LIN",
        "credential": "LCSW-R",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-25",
        "last_updated": "2012-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NY",
            "license": "073728",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CRISTA",
            "last_name": "SIMONETTI",
            "middle_name": "LIN",
            "prefix": "MRS.",
            "credential": "LCSW-R",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

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• Elizabeth Simitian, PA-C
• Simon Sanchez, Physician, PC
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• Lorin Singh, PSYD
• Tamaiiko Singleton, LMHC
• Tracy A. Sirc, M.S.
• Cheryl Skaggs, RN

• Mental Health Counselor in Bay Shore, NY
• Providers in Bay Shore, 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 Dec 21, 2012; 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.