Individual provider Active NPI

Shayana Supreme, LMHC

  • Mental Health Counselor
  • New City, NY
National Provider Identifier
1902597883
Registry record updated Oct 3, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
576214185 Issued in NY
Practice address
245 N Main St Unit 1241
New City, NY 10956-7585
Phone
(845) 893-5384
Fax
(845) 542-8534
NPI assigned
May 19, 2023
Last updated
Oct 3, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 3, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 576214185 NY Primary

Addresses

Primary practice location

245 N Main St Unit 1241
New City, NY 10956-7585

Mailing address

245 N Main St Unit 1241
New City, NY 10956-7585
Phone (845) 893-5384

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

LicenseStateTypeSpecialty
576214185NYMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Katarzyna Dlugosz Mental Health Counseling PLLC Mental Health CurrentSince May 21, 2023 Accepting new patients
Mind Body and Soul Mental Health Counseling PLLC Mental Health PastSince Nov 1, 2020 Accepting new patients

Locations

2 W 46th St
Ste 900
New York, NY 10036
Phone (646) 389-5887

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1684454400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1790985600000",
    "number": "1902597883",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "245 N MAIN ST UNIT 1241",
            "city": "NEW CITY",
            "state": "NY",
            "postal_code": "109567585",
            "telephone_number": "845-893-5384",
            "fax_number": "845-542-8534"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "245 N MAIN ST UNIT 1241",
            "city": "NEW CITY",
            "state": "NY",
            "postal_code": "109567585",
            "telephone_number": "845-893-5384",
            "fax_number": "845-542-8534"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUPREME",
        "first_name": "SHAYANA",
        "credential": "LMHC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-05-19",
        "last_updated": "2026-10-03",
        "certification_date": "2026-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NY",
            "license": "576214185",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New City, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2026; 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.