Individual provider Active NPI

Kesha Outlaw

  • Mental Health Counselor
  • New York, NY
National Provider Identifier
1841659752
Registry record updated Sep 8, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
2090 Adam Clayton Powell Jr Blvd
New York, NY 10027-4990
Phone
(347) 802-6429
NPI assigned
Feb 19, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 8, 2016

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 Primary

Addresses

Primary practice location

2090 Adam Clayton Powell Jr Blvd
New York, NY 10027-4990

Mailing address

405 E 92ND St
Apt 12a
New York, NY 10128-6814
Phone (347) 802-6429

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
I20240530000628 NY Practitioner - Mental Health Counselor 1759723166 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
New York Psychotherapy and Counseling Center CurrentSince Apr 21, 2024 Accepting new patients
Teladoc Health Medical Group, P.a. Mental Health Current Accepting new patients
Coordinated Behavioral Care Ipa Inc PastSince Apr 21, 2024 Accepting new patients

Locations

579 Courtlandt Ave
Bronx, NY 10451
Phone (718) 908-8000

102 Pilling St
Brooklyn, NY 11207
Phone (718) 602-1000

2857 Linden Blvd
Brooklyn, NY 11208
Phone (718) 235-3100

17620 148th Ave
Jamaica, NY 11434
Phone (718) 553-1100

Interoperability endpoints

  • Direct secure messaging: keshaoutlaw@tdh.allscriptsdirect.net

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1455840000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1473292800000",
    "number": "1841659752",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "405 E 92ND ST",
            "address_2": "APT 12A",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "101286814",
            "telephone_number": "347-802-6429"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2090 ADAM CLAYTON POWELL JR BLVD",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100274990",
            "telephone_number": "347-802-6429"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OUTLAW",
        "first_name": "KESHA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-02-19",
        "last_updated": "2016-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.