Individual provider Active NPI

Kathleen Sutherland

  • Mental Health Counselor
  • New York, NY
National Provider Identifier
1972962256
Registry record updated Sep 9, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
2090 Adam Clayton Powell Jr Blvd
New York, NY 10027-4990
Phone
(917) 485-7291
NPI assigned
Feb 16, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 9, 2016

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 Primary

Addresses

Primary practice location

2090 Adam Clayton Powell Jr Blvd
New York, NY 10027-4990

Mailing address

20 Leanore Dr
Farmingdale, NY 11735-5520

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
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
I20240206004634 CT Practitioner - Mental Health Counselor 0143663120 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Fordham University School of Medicine, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Family Centers IncGroup PAC ID 6507753324, 5 clinicians

Practice addresses (Care Compare)

20 Bridge St
Greenwich, CT 06830-5238
Phone (203) 629-2822

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Family Centers Inc CurrentSince Jan 2, 2024 Accepting new patients
Family Centers Inc CurrentSince Jan 2, 2024 Accepting new patients

Locations

20 Bridge St
Greenwich, CT 06830
Phone (203) 629-2822

986 Bedford St
Stamford, CT 06905
Phone (203) 324-3167

Organizations & group practices 2

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": "1455580800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1473379200000",
    "number": "1972962256",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 LEANORE DR",
            "city": "FARMINGDALE",
            "state": "NY",
            "postal_code": "117355520"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2090 ADAM CLAYTON POWELL JR BLVD",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100274990",
            "telephone_number": "917-485-7291"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUTHERLAND",
        "first_name": "KATHLEEN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-02-16",
        "last_updated": "2016-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.