Brandi Danielle Mack, MA-MFT, LMFT

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

0009181 Issued in NY

Practice address

17 E Genesee St Ste 1
Auburn, NY 13021-4068

Phone

(315) 253-9795

Fax

(315) 253-3255

NPI assigned

Jan 30, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Marriage and Family Therapist

Education

Other, 2004

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

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.

• Uplift Behavioral Health PC

  • Adult Mental Health Clinic/Center
  • Bethesda, MD
  • NPI 1629740410

  NY

  Medicare reassignment
• Marriage & Family Therapy Associates

  • Marriage & Family Therapist
  • Auburn, NY
  • NPI 1689942625
  NPD (past)

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

{
    "created_epoch": "1170115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1580342400000",
    "number": "1073659314",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6018 DUNNING AVE",
            "city": "AUBURN",
            "state": "NY",
            "postal_code": "130219823",
            "telephone_number": "210-291-7150"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17 E GENESEE ST STE 1",
            "city": "AUBURN",
            "state": "NY",
            "postal_code": "130214068",
            "telephone_number": "315-253-9795",
            "fax_number": "315-253-3255"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "33 William St Ste 5",
            "address_purpose": "LOCATION",
            "city": "Auburn",
            "state": "NY",
            "postal_code": "130213730",
            "country_code": "US",
            "telephone_number": "315-282-7076",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MACK",
        "first_name": "BRANDI",
        "middle_name": "DANIELLE",
        "name_prefix": "Ms.",
        "credential": "MA-MFT, LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-30",
        "last_updated": "2020-01-30",
        "certification_date": "2020-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "NY",
            "license": "0009181",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "181231501",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Gabriel C Lurvey, D.O.
• Jianxin Ma, M.D.
• Kathryn A Mabbett, PT
• Amy Hoeft Macdonald, MD
• Angelia A Mack, LMSW
• Nyla Malik, M.D.
• Malys Physical Therapy
• Mark C Malys, PT CHT
• Mark J Lawn Optician
• David Marker, CRNA

• Marriage & Family Therapist in Auburn, NY
• Providers in Auburn, NY by specialty
• Marriage & Family Therapist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.