Individual provider Active NPI

Shao-Yun Tai

  • Mental Health Counselor
  • Brooklyn, NY
National Provider Identifier
1760059349
Registry record updated Jun 10, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
P106652 Issued in NY
Practice address
810 Classon Ave
Brooklyn, NY 11238-6102
Phone
(718) 230-5100
NPI assigned
Jun 10, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 10, 2021

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 P106652 NY Primary

Addresses

Primary practice location

810 Classon Ave
Brooklyn, NY 11238-6102

Mailing address

20 River Rd Apt 12H
New York, NY 10044-1132
Phone (518) 256-7224

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240605003636 NY Practitioner - Mental Health Counselor 1759823768 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
P106652NYMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Seeing Mental Health Counseling PLLC Mental Health CurrentSince Apr 24, 2024 Accepting new patients
Community Counseling and Mediation CurrentSince Jun 15, 2021 Accepting new patients

Locations

810 Classon Ave
Brooklyn, NY 11238
Phone (718) 230-5100

19 W 34th St
Ph
New York, NY 10001
Phone (917) 297-8500

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": "1623283200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623283200000",
    "number": "1760059349",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 RIVER RD APT 12H",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100441132",
            "telephone_number": "518-256-7224"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "810 CLASSON AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112386102",
            "telephone_number": "718-230-5100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAI",
        "first_name": "SHAO-YUN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-06-10",
        "last_updated": "2021-06-10",
        "certification_date": "2021-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NY",
            "license": "P106652",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.