Individual provider Active NPI

Nancy Carol Korngold, LMHC

  • Addiction (Substance Use Disorder) Counselor
  • Staten Island, NY
National Provider Identifier
1912147885
Registry record updated Feb 22, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
CERT #11727 Issued in NY
Practice address
178 Oakville St
Staten Island, NY 10314-5053
Phone
(917) 502-1962
NPI assigned
Mar 4, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 22, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X CERT #11727 NY Primary
Mental Health Counselor 101YM0800X 002505-1 NY

Addresses

Primary practice location

178 Oakville St
Staten Island, NY 10314-5053

Mailing address

178 Oakville St
Staten Island, NY 10314-5053
Phone (718) 983-8193

Other identifiers 1

IdentifierTypeStateIssuer
UNKNOWNOtherNYMAGELAN BEHAVIORAL HEALTH

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
CERT #11727NYMDAddiction (Substance Use Disorder) Counselor
002505-1NYMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1236124800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1456099200000",
    "number": "1912147885",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "178 OAKVILLE ST",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103145053",
            "telephone_number": "718-983-8193"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "178 OAKVILLE ST",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103145053",
            "telephone_number": "917-502-1962"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KORNGOLD",
        "first_name": "NANCY",
        "middle_name": "CAROL",
        "credential": "LMHC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-03-04",
        "last_updated": "2016-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NY",
            "license": "CERT #11727",
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NY",
            "license": "002505-1",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAGELAN BEHAVIORAL HEALTH",
            "identifier": "UNKNOWN",
            "state": "NY"
        }
    ],
    "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 Feb 22, 2016; 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.