PHUNG MY LY LPCC, CDAC-II, MSCP
NPI 1215365739
Counselor - Professional in Newark, NJ

Q: What is Phung My Ly's NPI number?

The NPI number for Phung My Ly is 1215365739. It was assigned to this individual provider in the NPPES registry on October 18, 2013.

Q: What is Phung My Ly's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Professional, with taxonomy code 101YP2500X.

Q: When was this NPI record last updated?

The NPPES record for Phung My Ly was last updated on March 1, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since October 18, 2013PECOS Enrolled

1 GATEWAY CTR STE 2600, NEWARK, NJ 07102(888) 528-7618 Get Directions Write a Review

NPPES record last updated: March 1, 2024. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: May 14, 2021, Apr 28, 2017 (2 updates tracked since 2017).

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About Phung My Ly Lpcc, Cdac-ii, Mscp NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

PHUNG MY LY LPCC, CDAC-II, MSCP (NPI 1215365739) is an individual professional provider in Newark, New Jersey, licensed in New Jersey (37PC00989900) and active in the NPI registry since October 2013. She is enrolled in Medicare PECOS and is a graduate of Other (2008).

NPPES Registry Identity

NPI1215365739

Entity TypeIndividualFemale

Primary Taxonomy101YP2500X

Provider Legal NamePHUNG MY LYCredential: LPCC, CDAC-II, MSCP

Location Address1 GATEWAY CTR STE 2600Newark, NJ 07102-5323

Mailing Address228 Park Ave SNew York, NY 10003-1502 · (267) 999-9534

Phone(888) 528-7618

Sole ProprietorYes

Medical School CMSOtherGraduated 2008

Enumeration DateOctober 18, 2013

Last NPPES UpdateMarch 1, 20242 updates tracked since enumeration

NPPES CertifiedMarch 1, 2024

✔ NPI 1215365739 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyCounselor · ProfessionalBehavioral Health & Social Service Providers

Taxonomy Code101YP2500X

Licenses✔ Licensed in NJ · 37PC00989900✔ Licensed in CA · LPCC6684

Also ListedCounselor · Addiction (Substance Use Disorder)Taxonomy 101YA0400X · License RA9280413 (CA)

1 GATEWAY CTR STE 2600, Newark, NJ 07102

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Phung My Ly Lpcc, Cdac-ii, Mscp is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID8325543713

PECOS Enrollment IDI20250925004431

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Phung My Ly reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Medical Service Professionals Of Nj LLC

6.1 mi

Geriatric Medicine

125 CHUBB AVE, SUITE 100-S
Lyndhurst, NJ 07071

Reassigned Medicare billing, New Jersey enrollment
71 clinicians in this Medicare group

NPI 1972044923 (201) 559-7600

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MR. MICHAEL C CADORETTE ANP

Nurse Practitioner (Family)