Individual provider Active NPI

James Chukuemeke Egede, Sr, PH.D.

  • Mental Health Counselor
  • New York, NY
National Provider Identifier
1982990347
Registry record updated Jan 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
004054-1 Issued in NY
Practice address
125 Park Ave FL 25
New York, NY 10017-5550
Phone
(646) 982-0906
Fax
(718) 352-7495
NPI assigned
Jun 23, 2011
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 25, 2024

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 004054-1 NY Primary

Addresses

Primary practice location

125 Park Ave FL 25
New York, NY 10017-5550

Mailing address

125 Park Ave FL 25
New York, NY 10017-5550
Phone (718) 352-3703

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
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
004054-1NYMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Jaycee Consulting and Psychotherapy Associates Mental Health Current Accepting new patients

Locations

105 W 55th St
Apt Lf
New York, NY 10019
Phone (212) 757-2202

125 Park Ave
Fl 25
New York, NY 10017
Phone (201) 809-3000

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.

NPI Registry JSON

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

{
    "created_epoch": "1308787200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706140800000",
    "number": "1982990347",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "125 PARK AVE FL 25",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100175550",
            "telephone_number": "718-352-3703",
            "fax_number": "718-352-7495"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 PARK AVE FL 25",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100175550",
            "telephone_number": "646-982-0906",
            "fax_number": "718-352-7495"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EGEDE, SR",
        "first_name": "JAMES",
        "middle_name": "CHUKUEMEKE",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-06-23",
        "last_updated": "2024-01-25",
        "certification_date": "2024-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NY",
            "license": "004054-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 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.