Active NPI
Ann D Greenberg, LIC. ACC. CMHC
- Counselor
- Ithaca, NY
National Provider Identifier
1114450996
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- Practice address
- 408 Elm St
405 Taughanook Blvd.
Ithaca, NY 14850 - Phone
- (607) 272-7792
- Fax
- (607) 272-7792
- NPI assigned
- Apr 7, 2017
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | NY | Primary | |
| Mental Health Counselor | 101YM0800X | NY | ||
| Acupuncturist | 171100000X | 000759 | NY |
Addresses
Primary practice location
408 Elm St
405 Taughanook Blvd.
Ithaca, NY 14850
Mailing address
408 Elm St
Ithaca, NY 14850
Phone (607) 272-7792
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 12, 2024 through Jan 12, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 000759 | NY | MD | Psychoanalyst |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1491523200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1491523200000",
"number": "1114450996",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "408 ELM ST",
"city": "ITHACA",
"state": "NY",
"postal_code": "14850",
"telephone_number": "607-272-7792",
"fax_number": "607-272-7792"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "408 ELM ST",
"address_2": "405 TAUGHANOOK BLVD.",
"city": "ITHACA",
"state": "NY",
"postal_code": "14850",
"telephone_number": "607-272-7792",
"fax_number": "607-272-7792"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GREENBERG",
"first_name": "ANN",
"middle_name": "D",
"credential": "LIC. ACC. CMHC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2017-04-07",
"last_updated": "2017-04-07",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "NY",
"license": null,
"primary": true
},
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "NY",
"license": null,
"primary": false
},
{
"code": "171100000X",
"taxonomy_group": "",
"desc": "Acupuncturist",
"state": "NY",
"license": "000759",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ithaca, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2017; 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.