Individual provider Active NPI

Richard L Decrosta

  • Mental Health Counselor
  • Kingston, NY
National Provider Identifier
1770507014
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
001215 Issued in NY
Practice address
139 Cornell St
Kingston, NY 12401-3633
Phone
(845) 338-1234
Fax
(845) 338-6284
NPI assigned
Jul 27, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 001215 NY Primary

Addresses

Primary practice location

139 Cornell St
Kingston, NY 12401-3633

Mailing address

909 State Route 299
Gardiner, NY 12525-5022
Phone (845) 338-1234

Other identifiers 1

IdentifierTypeStateIssuer
001215OtherNYLICENSE

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
001215NYMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Nysarc Inc. Ulster, Greene, Putnam Counties Chapter PastSince Oct 12, 2015 Accepting new patients
Hudson Valley Health Specialties, Inc Past Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1153958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1770507014",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "909 STATE ROUTE 299",
            "city": "GARDINER",
            "state": "NY",
            "postal_code": "125255022",
            "telephone_number": "845-338-1234"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "139 CORNELL ST",
            "city": "KINGSTON",
            "state": "NY",
            "postal_code": "124013633",
            "telephone_number": "845-338-1234",
            "fax_number": "845-338-6284"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DECROSTA",
        "first_name": "RICHARD",
        "middle_name": "L",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NY",
            "license": "001215",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "001215",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kingston, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.