CAMELOT OF STATEN ISLAND, INC. (NPI# 1942359476) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1942359476 |
| Entity Type | Organization |
| Organization Name | CAMELOT OF STATEN ISLAND, INC. |
| Other Organization Name | CAMELOT COUNSELING CENTERS |
| Practice Address |
263 Port Richmond Avenue Staten Island NY 10302 |
| Mailing Address |
4442 Arthur Kill Rd Ste 4 Staten Island NY 10309-1321 |
| Practice Telephone | 7189818117 |
| Practice Fax Number | 7189818309 |
| Mailing Telephone | 7183565100 |
| Mailing Fax Number | 7189818309 |
| Enumeration Date | 2007-01-10 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MR. LUKE J. NASTA (EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 7183565100 |
| Authorized Official Credential | MPA, CASAC |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NY | 01292768 | 05 |
| Other Name | Type Code |
|---|---|
| Camelot Counseling Centers | Doing Business As Name - Organization |
| Street Address |
263 PORT RICHMOND AVENUE |
| City | STATEN ISLAND |
| State | NY |
| Zip Code | 10302 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306494174 | Denasia Fitch | Student in an Organized Health Care Education/Training Program | 80 Willowbrook Rd, Staten Island, NY 10302 | 2019-08-26 |
| 1548752983 | Lawan Rickenbacker | Counselor | 28 Treadwell Ave, Staten Island, NY 10302 | 2018-06-01 |
| 1275059321 | Omolara Rachael Adediji | Nurse Practitioner | 210 Trantor Place, Apt 1d, Staten Island, NY 10302 | 2017-08-21 |
| 1558893479 | Joseph Wilson | Substance Abuse Rehabilitation Facility | 273 Heberton Avenue, Staten Island, NY 10302 | 2017-03-30 |
| 1902358864 | Natalie Valencia Toney-zubairu | Nurse Practitioner | Community Health Center of Richmond, 235 Port Richmond Ave, Staten Island, NY 10302 | 2016-10-26 |
| 1912453788 | Adewunmi Bankole | Registered Nurse | 124 Nicholas Avenue Apt B, Staten Island, NY 10302 | 2016-08-31 |
| 1154788974 | Eileen Patricia Cameron | Counselor | 263-267 Port Richmond Aveune, Staten Island, NY 10302 | 2016-01-25 |
| 1225468432 | Total Dental Care of Staten Island, P.C. | Dentist | 135 Willowbrook Road, Staten Island, NY 10302 | 2013-11-25 |
| 1760723621 | Si. Senior Lifestyle Center Inc | Clinic/Center | 98 Port Richmond Ave, Staten Island, NY 10302 | 2013-03-01 |
| 1962751255 | Kathleen Gomez-rodriguez | Speech-Language Pathologist | 12 Crystal Ave, Staten Island, NY 10302 | 2012-09-03 |
| Find all providers in zip 10302 | ||||
| Taxonomy Code | 101YA0400X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Addiction (Substance Use Disorder) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134743776 | Prudence Salvato | Counselor | 109 Kelvin Ave, Staten Island, NY 10306-3743 | 2020-05-29 |
| 1487122511 | James Anthony Badillo | Counselor | 460 Brielle Ave Bldg H, Staten Island, NY 10314-6427 | 2018-11-07 |
| 1154706901 | Bilal Abdullah | Counselor | 1268 Forest Ave, Staten Island, NY 10302-2312 | 2015-07-22 |
| 1144603713 | Edwin Rivera | Counselor | 181 Mosely Ave, Staten Island, NY 10312-4163 | 2015-07-01 |
| 1508252420 | Melissa Forsyth | Counselor | 240 Woolley Ave, Staten Island, NY 10314-2002 | 2015-04-07 |
| 1508138355 | Georgener Winfield | Counselor | 263-267 Port Richmond Ave, Staten Island, NY 10302 | 2012-02-08 |
| 1073885687 | Carol A Casey | Counselor | 263 -267 Port Richmond Ave, Staten Island, NY 10302 | 2012-01-30 |
| 1275805871 | Barbara Carioti | Counselor | 263-267 Port Richmond Avenue, Staten Island, NY 10302 | 2012-01-30 |
| 1669743423 | Debora Blanford-gaskin | Counselor | 263/267 Port Richmond Ave, Staten Island, NY 10302 | 2012-01-25 |
| 1386915478 | Arthur Joseph Sagevick Jr. | Counselor | 3911 Richmond Avenue, Staten Island, NY 10312 | 2012-01-20 |
| Find all providers in STATEN ISLAND | ||||
| City | STATEN ISLAND |
| Zip Code | 10302 |
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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.