Active NPI
Gwendolyn Sullivan
- Mental Health Counselor
- Yorktown Heights, NY
National Provider Identifier
1730716754
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 009625
- Practice address
- 1940 Commerce St Ste 300
Yorktown Heights, NY 10598-4448 - Phone
- (914) 245-0437
- NPI assigned
- Mar 27, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 009625 | NY | Primary |
Addresses
Primary practice location
1940 Commerce St Ste 300
Yorktown Heights, NY 10598-4448
Mailing address
667 Stoneleigh Ave Ste 202
Carmel, NY 10512-2455
Phone (845) 279-5908
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Mental Health Counselor
- Education
- Other, 2015
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
4800 N Scottsdale Rd
Suite 2500
Scottsdale, AZ 85251-7630
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 009625 | NY | MD | Clinical Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Carmel Psychological Health, PC | Mental Health | Current | Accepting new patients |
Locations
667 Stoneleigh Ave
Ste 202
Carmel, NY 10512
Phone (845) 278-5223
1940 Commerce St
Ste 309
Yorktown Heights, NY 10598
Phone (844) 468-5391
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": "1585267200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1585267200000",
"number": "1730716754",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "667 STONELEIGH AVE STE 202",
"city": "CARMEL",
"state": "NY",
"postal_code": "105122455",
"telephone_number": "845-279-5908"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1940 COMMERCE ST STE 300",
"city": "YORKTOWN HEIGHTS",
"state": "NY",
"postal_code": "105984448",
"telephone_number": "914-245-0437"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SULLIVAN",
"first_name": "GWENDOLYN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-03-27",
"last_updated": "2020-03-27",
"certification_date": "2020-03-27",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "NY",
"license": "009625",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Yorktown Heights, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.