Anita H Stoudymire, CASAC

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

070511469 Issued in NY

Practice address

188 Genesee St
Suite 102
Auburn, NY 13021-3324

Phone

(315) 255-3559

Fax

(315) 255-3823

NPI assigned

Oct 28, 2008

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1225152000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1225152000000",
    "number": "1093968687",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "188 GENESEE ST",
            "city": "AUBURN",
            "state": "NY",
            "postal_code": "130213324",
            "telephone_number": "315-255-3559",
            "fax_number": "315-255-3823"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "188 GENESEE ST",
            "address_2": "SUITE 102",
            "city": "AUBURN",
            "state": "NY",
            "postal_code": "130213324",
            "telephone_number": "315-255-3559",
            "fax_number": "315-255-3823"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STOUDYMIRE",
        "first_name": "ANITA",
        "middle_name": "H",
        "name_prefix": "Ms.",
        "credential": "CASAC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-10-28",
        "last_updated": "2008-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NY",
            "license": "070511469",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Addiction (Substance Use Disorder) Counselor in Auburn, NY
• Providers in Auburn, NY by specialty
• Addiction (Substance Use Disorder) Counselor in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2008; 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.