Active NPI
Tiffany Berit Reilly, LMHC
- Mental Health Counselor
- Staten Island, NY
National Provider Identifier
1902519614
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 013003-01
- Practice address
- 143 Sturges St
Staten Island, NY 10314-3000 - Phone
- (973) 713-5721
- NPI assigned
- Dec 28, 2022
- Sex
- Female
- Sole proprietor
- No
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 | 013003-01 | NY | Primary |
Addresses
Primary practice location
143 Sturges St
Staten Island, NY 10314-3000
Mailing address
143 Sturges St
Staten Island, NY 10314-3000
Phone (973) 713-5721
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY, WA, NJ
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 3
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 013003-01 | NY | MD | Mental Health Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| MCCD New Jersey Psychiatry Services LLC | Current | Accepting new patients | |
| MCCD FL Psychiatry Services PA | Current | Accepting new patients | |
| MCCD Psychiatry Services PLLC | Current | Accepting new patients |
Locations
525 Route 73 N
Ste 117
Marlton, NJ 08053
Phone (609) 200-0444
109 W 27th St
#55
New York, NY 10001
109 W 27th St
Rm 5S
New York, NY 10001
Phone (332) 230-4572
13555 SE 36th St
Ste 100
Bellevue, WA 98006
Organizations & group practices 4
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.
-
- Psychiatry Physician
- New York, NY
- NPI 1033750823
-
- Psychiatry Physician
- Hampton, NJ
- NPI 1023729530
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- New York, NY
- NPI 1932975919
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1672185600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1672185600000",
"number": "1902519614",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "143 STURGES ST",
"city": "STATEN ISLAND",
"state": "NY",
"postal_code": "103143000",
"telephone_number": "973-713-5721"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "143 STURGES ST",
"city": "STATEN ISLAND",
"state": "NY",
"postal_code": "103143000",
"telephone_number": "973-713-5721"
}
],
"practiceLocations": [],
"basic": {
"last_name": "REILLY",
"first_name": "TIFFANY",
"middle_name": "BERIT",
"name_prefix": "Ms.",
"credential": "LMHC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-12-28",
"last_updated": "2022-12-28",
"certification_date": "2022-12-28",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "NY",
"license": "013003-01",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Staten Island, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.