DR. JOHANNA GOMEZ (NPI# 1457503120) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1457503120 |
| Entity Type | Individual |
| Full Name | DR. JOHANNA GOMEZ |
| Credential | LMHC |
| Practice Address |
1211 Stewart Ave Ste 100 Bethpage NY 11714 |
| Mailing Address |
1211 Stewart Ave Ste 100 Bethpage NY 11714-1601 |
| Practice Telephone | 5164653998 |
| Enumeration Date | 2008-10-14 |
| Last Update Date | 2018-08-29 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YM0800X |
Counselor Specialization: Mental Health |
Behavioral Health & Social Service Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 24 Target Ln, Levittown, NY 117561131 | 6462088598 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356622567 | Johanna Gomez | Nurse Practitioner | 7901 Broadway, Elmhurst, NY 11373-1329 | 2011-09-01 |
| 1285833491 | Johanna Gomez | Counselor | 1625 Schrader Blvd, Los Angeles, CA 90028-6213 | 2007-07-17 |
| Street Address |
1211 STEWART AVE STE 100 |
| City | BETHPAGE |
| State | NY |
| Zip Code | 11714 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568070316 | Stephanie Michelle Russell | Counselor | 1211 Stewart Ave Ste 100, Bethpage, NY 11714-1601 | 2020-07-17 |
| 1609421445 | Heather Quinn | Counselor | 1211 Stewart Ave Ste 100, Bethpage, NY 11714-1601 | 2019-08-08 |
| 1548823107 | Stephanie Avila | Counselor | 1211 Stewart Ave Ste 100, Bethpage, NY 11714-1601 | 2019-04-19 |
| 1144734187 | Brittany Hagemann | Counselor | 1211 Stewart Ave Ste 100, Bethpage, NY 11714-1601 | 2017-11-29 |
| 1114354339 | Tracey Giambertone | Dietitian, Registered | 1211 Stewart Ave Ste 100, Bethpage, NY 11714-1601 | 2013-10-02 |
| 1356778864 | Cody Tully Krawec | Dietitian, Registered | 1211 Stewart Ave Ste 100, Bethpage, NY 11714-1601 | 2013-09-28 |
| 1497046700 | The Berman Group for Wellness & Nutrition | Dietitian, Registered | 1211 Stewart Ave Ste 100, Bethpage, NY 11714-1601 | 2011-04-21 |
| 1861782369 | Deborah Anne Berman | Dietitian, Registered | 1211 Stewart Ave Ste 100, Bethpage, NY 11714-1601 | 2011-04-18 |
| 1235457490 | Kristen Elizabeth Herbert-delaney | Counselor | 1211 Stewart Ave Ste 100, Bethpage, NY 11714-1601 | 2010-05-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023466208 | Angelika Cataldo | Physician Assistant | 96 Farmers Ave, Bethpage, NY 11714 | 2016-05-30 |
| 1215390240 | Jessica Cohen Micciulli | Counselor | 1211 Stewart Ave., Suite 100, Bethpage, NY 11714 | 2016-03-29 |
| 1295119329 | Van Tu | Physician Assistant | 72 Roosevelt Dr, Bethpage, NY 11714 | 2015-07-18 |
| 1124400072 | Nicole Simon | Speech-Language Pathologist | 28 Lee Avenue, Bethpage, NY 11714 | 2015-06-26 |
| 1083001556 | Gagandeep Sharma | Podiatrist | 255 Stewart Ave, Bethpage, NY 11714 | 2015-04-22 |
| 1245631399 | All About Kids | Local Education Agency (LEA) | 152 Sycamore Avenue, Bethpage, NY 11714 | 2014-09-09 |
| 1568871440 | Christina Healy | Home Health Aide | 49 West Millpage Drive, Bethpage, NY 11714 | 2014-08-05 |
| 1225444656 | Ryan Vincent Costello | Registered Nurse | 68 S. 2nd St., Apt A, Bethpage, NY 11714 | 2014-07-07 |
| 1598195125 | Lori-ann Perez | Case Manager/Care Coordinator | 18 Ellen Street, Bethpage, NY 11714 | 2013-11-18 |
| 1306195482 | Lisa Kozlowsky | Behavioral Analyst | 420 Kensington Lane, Bethpage, NY 11714 | 2012-09-05 |
| Find all providers in zip 11714 | ||||
| Taxonomy Code | 101YM0800X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326681867 | Christina Maria Senatore | Counselor | 199 Central Ave, Bethpage, NY 11714-3907 | 2019-10-28 |
| 1013441401 | The Long Island Mental Health Counseling Group, PC | Counselor | 1211 Stewart Ave, Suite 100, Bethpage, NY 11714-1601 | 2017-04-12 |
| 1144770736 | Yevgeniya D'alessandro | Counselor | 11 Parkview Cir, Bethpage, NY 11714-2309 | 2016-10-07 |
| 1215390240 | Jessica Cohen Micciulli | Counselor | 1211 Stewart Ave., Suite 100, Bethpage, NY 11714 | 2016-03-29 |
| 1609257641 | Stephanie Hernandez | Counselor | 16 Devon Rd, Bethpage, NY 11714-1107 | 2015-06-16 |
| 1912388844 | Renata Nisenbaum | Counselor | 60 Devon Rd, Bethpage, NY 11714-1117 | 2015-06-16 |
| 1568070316 | Stephanie Michelle Russell | Counselor | 1211 Stewart Ave Ste 100, Bethpage, NY 11714-1601 | 2020-07-17 |
| 1912531526 | Brian Alvarez | Counselor | 4271 Hempstead Tpke, Bethpage, NY 11714-5708 | 2020-02-24 |
| 1609421445 | Heather Quinn | Counselor | 1211 Stewart Ave Ste 100, Bethpage, NY 11714-1601 | 2019-08-08 |
| 1548823107 | Stephanie Avila | Counselor | 1211 Stewart Ave Ste 100, Bethpage, NY 11714-1601 | 2019-04-19 |
| Find all providers in BETHPAGE | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.