Individual provider Active NPI

Yvon Serge Dimiyo, MA,MHA,MAPS

  • Counselor
  • Kenmore, NY
National Provider Identifier
1871140426
Registry record updated Sep 3, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
Practice address
262 Woodward Ave
Kenmore, NY 14217-1539
Phone
(716) 566-7771
NPI assigned
Aug 19, 2019
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 3, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X
Counselor 101Y00000X NY Primary

Addresses

Primary practice location

262 Woodward Ave
Kenmore, NY 14217-1539

Mailing address

262 Woodward Ave
Kenmore, NY 14217-1539
Phone (716) 566-7771

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
Credentials
Master of Arts

Practice roles

OrganizationSpecialtyStatusNew patients
Bestself Behavioral Health, Inc. PastSince Sep 6, 2020 Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1566172800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1599091200000",
    "number": "1871140426",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "262 WOODWARD AVE",
            "city": "KENMORE",
            "state": "NY",
            "postal_code": "142171539",
            "telephone_number": "716-566-7771"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "262 WOODWARD AVE",
            "city": "KENMORE",
            "state": "NY",
            "postal_code": "142171539",
            "telephone_number": "716-566-7771"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIMIYO",
        "first_name": "YVON",
        "middle_name": "SERGE",
        "credential": "MA,MHA,MAPS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-08-19",
        "last_updated": "2020-09-03",
        "certification_date": "2020-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "NY",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kenmore, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2020; 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.