Individual provider Active NPI

Irene Innya

  • Mental Health Counselor
  • Staten Island, NY
National Provider Identifier
1932659869
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
P03361 Issued in NY
Practice address
1216 Bay St
Staten Island, NY 10305-3169
Phone
(718) 390-5142
NPI assigned
Oct 4, 2016
Last updated
Mar 17, 2018By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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 P03361 NY Primary

Addresses

Primary practice location

1216 Bay St
Staten Island, NY 10305-3169

Mailing address

1216 Bay St
Staten Island, NY 10305-3169
Phone (718) 390-5142

Other practice location 1

1 74th St
Apt 5P
Brooklyn, NY 11209-1858
Phone (718) 801-2745

Other practice location 2

1 74th St
Apt 5P
Brooklyn, NY 11209-1858
Phone (718) 801-2745

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
P03361NYMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1475539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1932659869",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1216 BAY ST",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103053169",
            "telephone_number": "718-390-5142"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1216 BAY ST",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103053169",
            "telephone_number": "718-390-5142"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 74th St",
            "address_2": "Apt 5P",
            "address_purpose": "LOCATION",
            "city": "Brooklyn",
            "state": "NY",
            "postal_code": "112091858",
            "country_code": "US",
            "telephone_number": "718-801-2745",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1 74th St",
            "address_2": "Apt 5P",
            "address_purpose": "LOCATION",
            "city": "Brooklyn",
            "state": "NY",
            "postal_code": "112091858",
            "country_code": "US",
            "telephone_number": "718-801-2745",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "INNYA",
        "first_name": "IRENE",
        "name_prefix": "Ms.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-10-04",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NY",
            "license": "P03361",
            "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 Mar 17, 2018; 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.