Olive Oak Mental Health Counseling Services PC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Legal business name

OLIVE OAK MENTAL HEALTH COUNSELING SERVICES PC

Practice address

669 Main St Unit 505
New Rochelle, NY 10801-7101

Phone

(917) 438-8027

NPI assigned

May 20, 2024

Last updated

May 20, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Carolyn Burgos, LMHCNPI 1154754299

Title

Ceo and Clinical Administrator

Phone

(917) 439-8027

Specialties & licenses 1

Addresses

Electronic endpoints 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Carolyn Burgos, LMHC

  • Mental Health Counselor
  • New Rochelle, NY
  • NPI 1154754299
  NPD Authorized official

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

{
    "created_epoch": "1716163200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1716163200000",
    "number": "1851130942",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "669 MAIN ST UNIT 505",
            "city": "NEW ROCHELLE",
            "state": "NY",
            "postal_code": "108017101",
            "telephone_number": "917-438-8027"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "669 MAIN ST UNIT 505",
            "city": "NEW ROCHELLE",
            "state": "NY",
            "postal_code": "108017101",
            "telephone_number": "917-438-8027"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OLIVE OAK MENTAL HEALTH COUNSELING SERVICES PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-05-20",
        "last_updated": "2024-05-20",
        "certification_date": "2024-05-20",
        "status": "A",
        "authorized_official_last_name": "BURGOS",
        "authorized_official_first_name": "CAROLYN",
        "authorized_official_title_or_position": "CEO AND CLINICAL ADMINISTRATOR",
        "authorized_official_telephone_number": "917-439-8027",
        "authorized_official_credential": "LMHC"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "info@oliveoakmhc.org",
            "affiliation": "N",
            "endpointDescription": "Business Email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "669 Main St Unit 505",
            "city": "New Rochelle",
            "state": "NY",
            "country_code": "US",
            "postal_code": "108017101",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Mental Health Counselor in New Rochelle, NY
• Providers in New Rochelle, 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 May 20, 2024; 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.