Marie Nicole Clerisme

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

P90679 Issued in NY

Practice address

17810 Wexford Ter
Jamaica, NY 11432-3050

Phone

(718) 658-1123

Fax

(718) 658-4641

NPI assigned

Sep 17, 2013

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Mrs. Marie Nicole Clerisme Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1379376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1379376000000",
    "number": "1831525260",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "175 SALEM RD",
            "city": "WESTBURY",
            "state": "NY",
            "postal_code": "115901226",
            "telephone_number": "516-997-5547"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17810 WEXFORD TER",
            "city": "JAMAICA",
            "state": "NY",
            "postal_code": "114323050",
            "telephone_number": "718-658-1123",
            "fax_number": "718-658-4641"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLERISME",
        "first_name": "MARIE",
        "middle_name": "NICOLE",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-09-17",
        "last_updated": "2013-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NY",
            "license": "P90679",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARIE",
            "last_name": "CLERISME",
            "middle_name": "NICOLE",
            "prefix": "MRS.",
            "credential": "MHC",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

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• Mental Health Counselor in Jamaica, NY
• Providers in Jamaica, NY by specialty
• Mental Health Counselor in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2013; 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.