Individual provider Active NPI

Stacey Katz

  • Mental Health Counselor
  • Melville, NY
National Provider Identifier
1720436199
Registry record updated Mar 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
D008842 Issued in NY
Practice address
900 Walt Whitman Rd Ste 304
Melville, NY 11747-2215
Phone
(516) 962-1017
NPI assigned
May 26, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 13, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X P01278 NY
Mental Health Counselor 101YM0800X D008842 NY Primary

Addresses

Primary practice location

900 Walt Whitman Rd Ste 304
Melville, NY 11747-2215

Mailing address

24 High Ridge Rd
Plainview, NY 11803-1812
Phone (516) 962-1017

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

State licenses

LicenseStateTypeSpecialty
D008842NYMDMental Health Counselor
P01278NYMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Gold Coast Mental Health Counseling Current Accepting new patients
Teladoc Health Medical Group, P.a. Mental Health Current Accepting new patients

Locations

191 Broadway
Amityville, NY 11701
Phone (631) 204-0058

Interoperability endpoints

  • Direct secure messaging: staceykatz@tdh.allscriptsdirect.net

Organizations & group practices 2

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": "1464220800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741824000000",
    "number": "1720436199",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24 HIGH RIDGE RD",
            "city": "PLAINVIEW",
            "state": "NY",
            "postal_code": "118031812",
            "telephone_number": "516-962-1017"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 WALT WHITMAN RD STE 304",
            "city": "MELVILLE",
            "state": "NY",
            "postal_code": "117472215",
            "telephone_number": "516-962-1017"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KATZ",
        "first_name": "STACEY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-05-26",
        "last_updated": "2025-03-13",
        "certification_date": "2025-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NY",
            "license": "P01278",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NY",
            "license": "D008842",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Melville, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2025; 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.