Brian Matthew Gentile, LMHC, CRC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

001555 Issued in NY

Practice address

26 Century Hill Dr
Latham, NY 12110-2128

Phone

(518) 461-9780

NPI assigned

Jun 27, 2019

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1561593600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1561593600000",
    "number": "1972164184",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21 CENTERVIEW DR",
            "city": "TROY",
            "state": "NY",
            "postal_code": "121801916",
            "telephone_number": "518-461-9780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26 CENTURY HILL DR",
            "city": "LATHAM",
            "state": "NY",
            "postal_code": "121102128",
            "telephone_number": "518-461-9780"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "21 Centerview Dr",
            "address_purpose": "LOCATION",
            "city": "Troy",
            "state": "NY",
            "postal_code": "121801916",
            "country_code": "US",
            "telephone_number": "518-461-9780",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GENTILE",
        "first_name": "BRIAN",
        "middle_name": "MATTHEW",
        "name_prefix": "Mr.",
        "credential": "LMHC, CRC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-06-27",
        "last_updated": "2019-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NY",
            "license": "001555",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Mental Health Counselor in Latham, NY
• Providers in Latham, NY by specialty
• Mental Health Counselor in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2019; 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.