Organization Active NPI

Phoenix Within Mental Health Counseling LLC

  • Mental Health Counselor
  • Huntington, NY
National Provider Identifier
1962103523
Registry record updated Feb 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Legal business name
PHOENIX WITHIN MENTAL HEALTH COUNSELING LLC
Practice address
775 Park Ave Ste 255
Huntington, NY 11743-7538
Phone
(917) 699-8794
NPI assigned
Mar 10, 2023
Last updated
Feb 8, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 8, 2024

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

Authorized official

Name
Ms. Gabrielle Marie Ricca-Caldon, LMHCNPI 1124558499
Title
Owner/Provider
Phone
(917) 581-2834

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

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

Addresses

Primary practice location

775 Park Ave Ste 255
Huntington, NY 11743-7538

Mailing address

775 Park Ave Ste 380
Huntington, NY 11743-7573
Phone (917) 699-8794

National Provider Directory

National Provider Directory

Locations

775 Park Ave
Ste 380
Huntington, NY 11743
Phone (516) 914-6043

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1678406400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1707350400000",
    "number": "1962103523",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "775 PARK AVE STE 380",
            "city": "HUNTINGTON",
            "state": "NY",
            "postal_code": "117437573",
            "telephone_number": "917-699-8794"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "775 PARK AVE STE 255",
            "city": "HUNTINGTON",
            "state": "NY",
            "postal_code": "117437538",
            "telephone_number": "917-699-8794"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHOENIX WITHIN MENTAL HEALTH COUNSELING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-03-10",
        "last_updated": "2024-02-08",
        "certification_date": "2024-02-08",
        "status": "A",
        "authorized_official_last_name": "RICCA-CALDON",
        "authorized_official_first_name": "GABRIELLE",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "OWNER/PROVIDER",
        "authorized_official_telephone_number": "917-581-2834",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "LMHC"
    },
    "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 Huntington, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2024; 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.