Individual provider Active NPI

Robert Ellis Power Jr., PH. D

  • Addiction (Substance Use Disorder) Counselor
  • Brooklyn, NY
National Provider Identifier
1770046658
Registry record updated Feb 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
35587 Issued in NY
Practice address
1007 Atlantic Ave Apt 4D
Brooklyn, NY 11238-3469
Phone
(516) 586-0001
Fax
(516) 530-1838
NPI assigned
Apr 9, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 8, 2024

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Pastoral Counselor 101YP1600X EXEMPT NY
Case Manager/Care Coordinator 171M00000X
Community Health Worker 172V00000X 3476 NY
Peer Specialist 175T00000X 3476 NY
Addiction (Substance Use Disorder) Counselor 101YA0400X 35587 NY Primary

Addresses

Primary practice location

1007 Atlantic Ave Apt 4D
Brooklyn, NY 11238-3469

Mailing address

77 Sands St FL 6
Brooklyn, NY 11201-1431
Phone (516) 586-0001

Other identifiers 3

IdentifierTypeStateIssuer
CARP-3476OtherNY CERTIFICATION BOARD - ASAP OF NEW YORK
01799OtherGAALCOHOL AND DRUG ABUSE CERTIFICATION BOARD OF GEORGIA (ADACBGA)
35587OtherNYOFFICE OF ADDICTION SERVICES AND SUPPORTS

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
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
35587NYMDAddiction (Substance Use Disorder) Counselor
EXEMPTNYMDPastoral Counselor
3476NYMDPeer Specialist

NPI Registry JSON

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

{
    "created_epoch": "1554768000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707350400000",
    "number": "1770046658",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "77 SANDS ST FL 6",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112011431",
            "telephone_number": "516-586-0001",
            "fax_number": "516-530-1838"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1007 ATLANTIC AVE APT 4D",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112383469",
            "telephone_number": "516-586-0001",
            "fax_number": "516-530-1838"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POWER",
        "first_name": "ROBERT",
        "middle_name": "ELLIS",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "PH. D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-04-09",
        "last_updated": "2024-02-08",
        "certification_date": "2024-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP1600X",
            "taxonomy_group": "",
            "desc": "Counselor, Pastoral",
            "state": "NY",
            "license": "EXEMPT",
            "primary": false
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": "NY",
            "license": "3476",
            "primary": false
        },
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": "NY",
            "license": "3476",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NY",
            "license": "35587",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NY CERTIFICATION BOARD - ASAP OF NEW YORK",
            "identifier": "CARP-3476",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ALCOHOL AND DRUG ABUSE CERTIFICATION BOARD OF GEORGIA (ADACBGA)",
            "identifier": "01799",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OFFICE OF ADDICTION SERVICES AND SUPPORTS",
            "identifier": "35587",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2024; 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.