Active NPI
Kathleen Lao
- Professional Counselor
- Medford, NY
National Provider Identifier
1952763716
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 091263-1
- Practice address
- 31 Industrial Blvd
Medford, NY 11763-2220 - Phone
- (631) 924-4411
- NPI assigned
- Mar 22, 2016
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 091263-1 | NY | Primary |
Addresses
Primary practice location
31 Industrial Blvd
Medford, NY 11763-2220
Mailing address
31 Industrial Blvd
Medford, NY 11763-2220
Phone (631) 924-4411
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 |
|---|---|---|---|
| 091263-1 | NY | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| The Yaphank Center | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Community/Behavioral Health Agency
- Medford, NY
- NPI 1790147411
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1458604800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1458604800000",
"number": "1952763716",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "31 INDUSTRIAL BLVD",
"city": "MEDFORD",
"state": "NY",
"postal_code": "117632220",
"telephone_number": "631-924-4411"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "31 INDUSTRIAL BLVD",
"city": "MEDFORD",
"state": "NY",
"postal_code": "117632220",
"telephone_number": "631-924-4411"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LAO",
"first_name": "KATHLEEN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-03-22",
"last_updated": "2016-03-22",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "NY",
"license": "091263-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Medford, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 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.