Individual provider Active NPI

Cheryl Edmond, CASAC

  • Addiction (Substance Use Disorder) Counselor
  • Bronx, NY
National Provider Identifier
1801374038
Registry record updated Jul 31, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
17787 Issued in NY
Practice address
1523 Jarvis Ave
Bronx, NY 10461-5604
Phone
(347) 880-6466
NPI assigned
Jul 31, 2018
Last updated
Jul 31, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 31, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 17787 NY Primary

Addresses

Primary practice location

1523 Jarvis Ave
Bronx, NY 10461-5604

Mailing address

2976 Northern Blvd
Long Island City, NY 11101-2822
Phone (347) 510-3643

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
17787NYMDAddiction (Substance Use Disorder) Counselor

NPI Registry JSON

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

{
    "created_epoch": "1532995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1532995200000",
    "number": "1801374038",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2976 NORTHERN BLVD",
            "city": "LONG ISLAND CITY",
            "state": "NY",
            "postal_code": "111012822",
            "telephone_number": "347-510-3643"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1523 JARVIS AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104615604",
            "telephone_number": "347-880-6466"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDMOND",
        "first_name": "CHERYL",
        "credential": "CASAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-07-31",
        "last_updated": "2018-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NY",
            "license": "17787",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2018; 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.