Individual provider Active NPI

Chelsea Mojallali

  • Mental Health Counselor
  • Bohemia, NY
National Provider Identifier
1811752819
Registry record updated Jan 5, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
017259 Issued in NY
Practice address
4109 Sunrise Hwy
Bohemia, NY 11716-4600
Phone
(631) 552-5524
NPI assigned
Feb 19, 2024
Last updated
Jan 5, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 5, 2026

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 017259 NY Primary

Addresses

Primary practice location

4109 Sunrise Hwy
Bohemia, NY 11716-4600

Mailing address

71 Evergreen LN
East Patchogue, NY 11772-5805
Phone (631) 609-7002

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260511000218 NY Practitioner - Mental Health Counselor 5890263644 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2023
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1055 Alcorn Ter
Midlothian, VA 23114-4338

4109 Sunrise Hwy
Bohemia, NY 11716

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Organizations & group practices 1

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": "1708300800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1767571200000",
    "number": "1811752819",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "71 EVERGREEN LN",
            "city": "EAST PATCHOGUE",
            "state": "NY",
            "postal_code": "117725805",
            "telephone_number": "631-609-7002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4109 SUNRISE HWY",
            "city": "BOHEMIA",
            "state": "NY",
            "postal_code": "117164600",
            "telephone_number": "631-552-5524"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOJALLALI",
        "first_name": "CHELSEA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-02-19",
        "last_updated": "2026-01-05",
        "certification_date": "2026-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NY",
            "license": "017259",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bohemia, NY

Sources for this page

Verify at the official NPI Registry.