Individual provider Active NPI

Sandra Campohermoso, LMHC

  • Mental Health Counselor
  • Coram, NY
National Provider Identifier
1780420216
Registry record updated Jul 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
3600 Route 112
Coram, NY 11727-4116
Phone
(631) 920-8500
Fax
(631) 920-8477
NPI assigned
Jul 3, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 3, 2024

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 NY Primary

Addresses

Primary practice location

3600 Route 112
Coram, NY 11727-4116

Mailing address

3141 Union Blvd
East Islip, NY 11730-1904
Phone (631) 745-8347

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

NPI Registry JSON

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

{
    "created_epoch": "1719964800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719964800000",
    "number": "1780420216",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3141 UNION BLVD",
            "city": "EAST ISLIP",
            "state": "NY",
            "postal_code": "117301904",
            "telephone_number": "631-745-8347"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3600 ROUTE 112",
            "city": "CORAM",
            "state": "NY",
            "postal_code": "117274116",
            "telephone_number": "631-920-8500",
            "fax_number": "631-920-8477"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAMPOHERMOSO",
        "first_name": "SANDRA",
        "credential": "LMHC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-07-03",
        "last_updated": "2024-07-03",
        "certification_date": "2024-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NY",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Coram, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 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.