Jacqueline Abbanat, MHC – Mental Health Counselor

Key facts

NPI: 1891421335
Entity type: Individual (NPI type 1)
Primary specialty: Mental Health Counselor 101YM0800X
License: P116297 (NY)
Practice address: 633 Gidney Ave Ste 6
Newburgh, NY 12550-2805
Phone: (845) 569-2900
NPI assigned: Jul 27, 2022
Sex: Female
Sole proprietor: No

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.

Wendy Keller, LCSW, LLC Clinical Social Worker · Newburgh, NY · NPI 1982992889

NPD

Medicare participation

Medicare fee-for-service enrollment: Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD): No

State licenses

License	State	Type	Specialty
P116297	NY	MD	Mental Health Counselor

Practice roles

Organization	Specialty	Status	New patients
Wendy Keller, LCSW, LLC		Current since Jul 31, 2022	Accepting new patients

Locations

633 Gidney Ave
Ste 6
Newburgh, NY 12550
Phone (845) 242-8375

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Mental Health Counselor	101YM0800X	P116297	NY	Yes

Addresses

Primary practice location

633 Gidney Ave Ste 6
Newburgh, NY 12550-2805

Mailing address

35 Alexander Dr
Washingtonville, NY 10992-1203
Phone (845) 216-7281

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jul 27, 2022.

{
    "created_epoch": "1658880000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658880000000",
    "number": "1891421335",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "35 ALEXANDER DR",
            "city": "WASHINGTONVILLE",
            "state": "NY",
            "postal_code": "109921203",
            "telephone_number": "845-216-7281"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "633 GIDNEY AVE STE 6",
            "city": "NEWBURGH",
            "state": "NY",
            "postal_code": "125502805",
            "telephone_number": "845-569-2900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ABBANAT",
        "first_name": "JACQUELINE",
        "credential": "MHC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-07-27",
        "last_updated": "2022-07-27",
        "certification_date": "2022-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NY",
            "license": "P116297",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newburgh, NY

All providers in Newburgh, NY · Mental Health Counselor in New York

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 27, 2022. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.