Active NPI
Evelyn Roberts
- Mental Health Counselor
- Freeport, NY
National Provider Identifier
1811158595
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 081293
- Practice address
- 17 West Merrick Road
Freeport, NY 11520 - Phone
- (516) 528-4600
- NPI assigned
- Jun 24, 2008
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 081293 | NY | Primary |
Addresses
Primary practice location
17 West Merrick Road
Freeport, NY 11520
Mailing address
17 W Merrick Rd
Freeport, NY 11520-3873
Phone (516) 528-4600
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
| License | State | Type | Specialty |
|---|---|---|---|
| 081293 | NY | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1214265600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1292457600000",
"number": "1811158595",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "17 W MERRICK RD",
"city": "FREEPORT",
"state": "NY",
"postal_code": "115203873",
"telephone_number": "516-528-4600"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "17 WEST MERRICK ROAD",
"city": "FREEPORT",
"state": "NY",
"postal_code": "11520",
"telephone_number": "516-528-4600"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROBERTS",
"first_name": "EVELYN",
"name_prefix": "Mrs.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-06-24",
"last_updated": "2010-12-16",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "NY",
"license": "081293",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Freeport, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.