Active NPI
Nicholas Jefferson, CASAC-G
- Addiction (Substance Use Disorder) Counselor
- Bronx, NY
National Provider Identifier
1912444282
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- License
- 30878
- Practice address
- 1910 Arthur Ave
Bronx, NY 10457-6305 - Phone
- (718) 583-5150
- NPI assigned
- Jan 25, 2017
- Last updated
- Jan 25, 2017
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 30878 | NY | Primary |
Addresses
Primary practice location
1910 Arthur Ave
Bronx, NY 10457-6305
Mailing address
1020 Trinity Ave Apt 10G
Bronx, NY 10456-6915
Phone (718) 583-5150
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
| License | State | Type | Specialty |
|---|---|---|---|
| 30878 | NY | MD | Addiction (Substance Use Disorder) Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1485302400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1485302400000",
"number": "1912444282",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1020 TRINITY AVE APT 10G",
"city": "BRONX",
"state": "NY",
"postal_code": "104566915",
"telephone_number": "718-583-5150"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1910 ARTHUR AVE",
"city": "BRONX",
"state": "NY",
"postal_code": "104576305",
"telephone_number": "718-583-5150"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JEFFERSON",
"first_name": "NICHOLAS",
"name_prefix": "Mr.",
"credential": "CASAC-G",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-01-25",
"last_updated": "2017-01-25",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "NY",
"license": "30878",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bronx, NY
- Nadira Melissa Jeeuth
- Shakia Jeffers, LPN
- Jefferson Pharma LLC (Feel Good Pharmacy)
- Christopher T Jefferson, LMSW
- Karen Jefferson, RPA
- Jeffrey Cooper O.D., P.C. (Metro Optics)
- Jeffrey Cooper O.D., P.C. (Metro Optics)
- Jeffrey Cooper O.D., P.C. (Metro Optics)
- Jeffrey Cooper O.D., P.C. (Metro Optics)
- Ambrozine Jeffrey, REGISTERED NURSE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.