Active NPI
Edward Clayton Vandyke, LMHC
- Mental Health Counselor
- Clinton, NY
National Provider Identifier
1851553853
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 001000 1
- Practice address
- 2 Williams St FL 2
Clinton, NY 13323-1706 - Phone
- (315) 527-6062
- NPI assigned
- Jun 30, 2008
- Sex
- Male
- Sole proprietor
- Yes
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 | 001000 1 | NY | Primary |
Addresses
Primary practice location
2 Williams St FL 2
Clinton, NY 13323-1706
Mailing address
2 Williams St FL 2
Clinton, NY 13323-1706
Phone (315) 527-6062
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 |
|---|---|---|---|
| 001000 1 | NY | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1214784000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1214956800000",
"number": "1851553853",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2 WILLIAMS ST FL 2",
"city": "CLINTON",
"state": "NY",
"postal_code": "133231706",
"telephone_number": "315-527-6062"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2 WILLIAMS ST FL 2",
"city": "CLINTON",
"state": "NY",
"postal_code": "133231706",
"telephone_number": "315-527-6062"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VANDYKE",
"first_name": "EDWARD",
"middle_name": "CLAYTON",
"name_prefix": "Mr.",
"credential": "LMHC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2008-06-30",
"last_updated": "2008-07-02",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "NY",
"license": "001000 1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Clinton, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.