Individual provider Active NPI

Mary Beth D'Amico, MS LMHC

  • Mental Health Counselor
  • Oswego, NY
National Provider Identifier
1104013812
Registry record updated Jul 18, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
000899-1 Issued in NY
Practice address
5 West Cayuga St
Integrative Services Inc.
Oswego, NY 13126
Phone
(315) 342-9255
NPI assigned
Sep 26, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 18, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 000899-1 NY Primary
Case Manager/Care Coordinator 171M00000X

Addresses

Primary practice location

5 West Cayuga St
Integrative Services Inc.
Oswego, NY 13126

Mailing address

PO Box 5246
Oswego, NY 13126-5246
Phone (315) 598-0650

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.
Opted out of Medicare
Yes, effective Jan 19, 2024 through Jan 19, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
000899-1NYMDAthletic Trainer

Practice roles

OrganizationSpecialtyStatusNew patients
Integrative Mental Health Counseling Services, PLLC Mental Health Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1190764800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1342569600000",
    "number": "1104013812",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5246",
            "city": "OSWEGO",
            "state": "NY",
            "postal_code": "131265246",
            "telephone_number": "315-598-0650"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 WEST CAYUGA ST",
            "address_2": "INTEGRATIVE SERVICES INC.",
            "city": "OSWEGO",
            "state": "NY",
            "postal_code": "13126",
            "telephone_number": "315-342-9255"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "D'AMICO",
        "first_name": "MARY",
        "middle_name": "BETH",
        "name_prefix": "Mrs.",
        "credential": "MS LMHC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-09-26",
        "last_updated": "2012-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NY",
            "license": "000899-1",
            "primary": true
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oswego, NY

Sources for this page

Verify at the official NPI Registry.