NPIMap

Organization Active NPI

Safe Space Nyc, Inc.

  • Mental Health Counselor
  • Jamaica, NY
National Provider Identifier
1760532279
Registry record updated Nov 7, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
7055120A Issued in NY
Legal business name
SAFE SPACE NYC, INC.
Practice address
16318 Jamaica Ave
Jamaica, NY 11432-4901
Phone
(718) 206-3440
Fax
(718) 206-3638
NPI assigned
Jan 10, 2007
Last updated
Nov 7, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 7, 2016

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

Authorized official

Name
Evelyn Eccles
Title
Controller
Phone
(212) 886-5617

Specialties & licenses 9

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 7055120A NY Primary
Clinical Social Worker 1041C0700X 7055120A NY
Clinical Social Worker 1041C0700X 7055120C NY
Clinical Social Worker 1041C0700X 7055120B NY
Psychiatry Physician 2084P0800X 7055120A NY
Psychiatry Physician 2084P0800X 7055120B NY
Child & Adolescent Psychiatry Physician 2084P0804X 7055120A NY
Child & Adolescent Psychiatry Physician 2084P0804X 7055120B NY
Child & Adolescent Psychiatry Physician 2084P0804X 7055120C NY

Addresses

Primary practice location

16318 Jamaica Ave
Jamaica, NY 11432-4901

Mailing address

8974 162ND St
5TH Floor
Jamaica, NY 11432-5072
Phone (718) 526-2400

Other identifiers 1

IdentifierTypeStateIssuer
00368387MedicaidNY

Other names 1

  • The Center for Children & Families Former legal business name

National Provider Directory

National Provider Directory
Tax ID family
Safe Space Nyc Inc3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 9

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1168387200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1478476800000",
    "number": "1760532279",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8974 162ND ST",
            "address_2": "5TH FLOOR",
            "city": "JAMAICA",
            "state": "NY",
            "postal_code": "114325072",
            "telephone_number": "718-526-2400",
            "fax_number": "718-526-3180"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16318 JAMAICA AVE",
            "city": "JAMAICA",
            "state": "NY",
            "postal_code": "114324901",
            "telephone_number": "718-206-3440",
            "fax_number": "718-206-3638"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAFE SPACE NYC, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-10",
        "last_updated": "2016-11-07",
        "status": "A",
        "authorized_official_last_name": "ECCLES",
        "authorized_official_first_name": "EVELYN",
        "authorized_official_title_or_position": "CONTROLLER",
        "authorized_official_telephone_number": "212-886-5617"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NY",
            "license": "7055120A",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "7055120A",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "7055120C",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "7055120B",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NY",
            "license": "7055120A",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NY",
            "license": "7055120B",
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "NY",
            "license": "7055120A",
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "NY",
            "license": "7055120B",
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "NY",
            "license": "7055120C",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00368387",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Center for Children & Families",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Jamaica, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2016; 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.