Erinne Gibson
Individual provider Active NPI Mental Health Counselor · Pine City, NY
NPI 1104247345 · NPPES record last updated Sep 19, 2024
Key facts
- NPI
- 1104247345
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Mental Health Counselor 101YM0800X
- Practice address
- 1520 Pennsylvania Ave
Pine City, NY 14871-9108 - Phone
- (607) 331-3121
- NPI assigned
- Dec 13, 2013
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 3
Medicare Care Compare profile
- Specialty
- Mental Health Counselor
- Education
- Other
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
PO Box
Dallas, TX 75373
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NY
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20250905000647 | NY | Practitioner - Mental Health Counselor | 0143722553 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Wagner Medical PC | Current |
Accepting new patients | |
| Soulful Serenity, Mental Health Counseling Services, PLLC. | Mental Health | Current |
Accepting new patients |
| Resilience Psychotherapy LCSW PC | Past | Accepting new patients |
Locations
100 Church St
Fl 8
New York, NY 10007
Phone (646) 357-3609
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Analyst | 103K00000X | |||
| Mental Health Counselor | 101YM0800X | Yes |
Addresses
Primary practice location
1520 Pennsylvania Ave
Pine City, NY 14871-9108
Mailing address
1520 Pennsylvania Ave
Pine City, NY 14871-9108
Phone (607) 331-3121
Other practice location 1
115 Liberty St
Bath, NY 14810-1508
Phone (607) 664-2156 ext. 4089
Other practice location 2
224 Alexander St
Rochester, NY 14607-4000
Phone (585) 922-7770
Other providers in Pine City, NY
- Katrina Cady
- Compassionate Companion Care, PLLC
- Doris Farmer-Raymond
- Sara L Frunzi
- Joan M Gensel
- Thomas R. Gustafson
- Guthrie Clinic LTD
- Guthrie Medical Group, P.C.
- Andrea E Herman
- Inner Lakes Therapy PLLC
All providers in Pine City, NY · Mental Health Counselor in New York
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 19, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.