Kristen Beeles, LMHC, CASAC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

010481 Issued in NY

Practice address

321 W Onondaga St
Syracuse, NY 13202-3262

Phone

(153) 478-0610

NPI assigned

Apr 7, 2015

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Ms. Kristen Dougherty Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Central New York Services, Inc.

  • Multi-Specialty Clinic/Center
  • Utica, NY
  • NPI 1407363492
  NPD (past)
• Central New York Services, Inc.

  • Adult Mental Health Clinic/Center
  • Syracuse, NY
  • NPI 1821491903
  NPD (past)
• Conifer Park, Inc.

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Glenville, NY
  • NPI 1336339969
  NPD (past)
• Conifer Park, Inc.

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Liverpool, NY
  • NPI 1366498768
  NPD (past)

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

{
    "created_epoch": "1428364800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1590710400000",
    "number": "1003202052",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "321 W ONONDAGA ST",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132023262",
            "telephone_number": "315-478-0610"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "321 W ONONDAGA ST",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132023262",
            "telephone_number": "153-478-0610"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEELES",
        "first_name": "KRISTEN",
        "name_prefix": "Mrs.",
        "credential": "LMHC, CASAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-04-07",
        "last_updated": "2020-05-29",
        "certification_date": "2020-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NY",
            "license": "30427",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NY",
            "license": "010481",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01420800",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KRISTEN",
            "last_name": "DOUGHERTY",
            "prefix": "MS.",
            "credential": "CASAC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Heather N Bedard, CPNP-PC
• Thomas Alexander Bedard, MD
• Deborah Bedford, NP
• Jadwiga J. Bednarczyk, MD
• Dana Christine Beebe, FNP
• Emily Beeman
• Catherine Elizabeth Beer, FNP-C
• Jacob Carl Beer, DO
• Celine Flannery Beers, RN
• Richard A Beers

• All providers in Syracuse, NY
• Mental Health Counselor in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2020; 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.