Active NPI
Kimberly Brandl
- Mental Health Counselor
- Syracuse, NY
National Provider Identifier
1003323262
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- PO3869
- Practice address
- 202 Walton St Ste 200
Syracuse, NY 13202-1373 - Phone
- (315) 204-0610
- Fax
- (315) 260-4332
- NPI assigned
- Jan 9, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | PO3869 | NY | Primary |
Addresses
Primary practice location
202 Walton St Ste 200
Syracuse, NY 13202-1373
Mailing address
141 County Route 23a
Constantia, NY 13044-3737
Phone (315) 204-0610
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Jan 1, 2024 through Jan 1, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PO3869 | NY | MD | Mental Health Counselor |
| 008510 | NY | MD | Pediatric Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1515456000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1767052800000",
"number": "1003323262",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "141 COUNTY ROUTE 23A",
"city": "CONSTANTIA",
"state": "NY",
"postal_code": "130443737",
"telephone_number": "315-204-0610",
"fax_number": "315-260-4332"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "202 WALTON ST STE 200",
"city": "SYRACUSE",
"state": "NY",
"postal_code": "132021373",
"telephone_number": "315-204-0610",
"fax_number": "315-260-4332"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRANDL",
"first_name": "KIMBERLY",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-01-09",
"last_updated": "2025-12-30",
"certification_date": "2025-12-30",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "NY",
"license": "PO3869",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Syracuse, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.