Individual provider Active NPI

Anastasiya Vladychack

  • Mental Health Counselor
  • Plainview, NY
National Provider Identifier
1922687672
Registry record updated May 3, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
55 W Ames CT
Plainview, NY 11803-2304
Phone
(516) 822-6111
NPI assigned
Apr 7, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 3, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YM0800X Primary

Addresses

Primary practice location

55 W Ames CT
Plainview, NY 11803-2304

Mailing address

55 W Ames CT
Plainview, NY 11803-2304
Phone (516) 822-6111

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240207000399 NY Practitioner - Mental Health Counselor 2567805575 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Mental Health Specialty Group PA Mental Health CurrentSince May 1, 2025 Accepting new patients
Sunrise Counseling Center,LTD Single Specialty CurrentSince Jan 19, 2024 Accepting new patients
Shine Medical PC Single Specialty Past Accepting new patients

Locations

107 W Main St
East Islip, NY 11730
Phone (631) 666-1615

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1617753600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620000000000",
    "number": "1922687672",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 W AMES CT",
            "city": "PLAINVIEW",
            "state": "NY",
            "postal_code": "118032304",
            "telephone_number": "516-822-6111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 W AMES CT",
            "city": "PLAINVIEW",
            "state": "NY",
            "postal_code": "118032304",
            "telephone_number": "516-822-6111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VLADYCHACK",
        "first_name": "ANASTASIYA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-04-07",
        "last_updated": "2021-05-03",
        "certification_date": "2021-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plainview, NY

Sources for this page

Verify at the official NPI Registry.