Individual provider Active NPI

Kristen A Meder, LMHC

  • Mental Health Counselor
  • Irving, NY
National Provider Identifier
1124563382
Registry record updated Apr 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
009514 Issued in NY
Practice address
275 Thomas Indian School Dr
Irving, NY 14081-9341
Phone
(716) 532-5582
Fax
(716) 242-6344
NPI assigned
Dec 27, 2016
Last updated
Apr 21, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 21, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 009514 NY Primary

Addresses

Primary practice location

275 Thomas Indian School Dr
Irving, NY 14081-9341

Mailing address

39 N Pangolin St Apt a
Dunkirk, NY 14048-1150
Phone (716) 785-3698

Other practice location 1

987 R C Hoag Dr
Salamanca, NY 14779-1365
Phone (716) 945-5894

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20240418003976 NY Practitioner - Mental Health Counselor 0941649206 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Seneca Nation of IndiansGroup PAC ID 8123920592, 29 clinicians

Practice addresses (Care Compare)

275 Thomas Indian School Dr
Irving, NY 14081-9341
Phone (716) 532-5582

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Seneca Nation of Indians CurrentSince Mar 3, 2024 Accepting new patients
Seneca Nation of Indians CurrentSince Mar 3, 2024 Accepting new patients
Seneca Nation of Indians Past Accepting new patients

Locations

275 Thomas Indian School Dr
Irving, NY 14081
Phone (716) 532-5582

36 Thomas Indian School Dr
Irving, NY 14081
Phone (716) 532-5582

987 R C Hoag Dr
Salamanca, NY 14779
Phone (716) 945-5894

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1482796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745193600000",
    "number": "1124563382",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "39 N PANGOLIN ST APT A",
            "city": "DUNKIRK",
            "state": "NY",
            "postal_code": "140481150",
            "telephone_number": "716-785-3698"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "275 THOMAS INDIAN SCHOOL DR",
            "city": "IRVING",
            "state": "NY",
            "postal_code": "140819341",
            "telephone_number": "716-532-5582",
            "fax_number": "716-242-6344"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "987 R C Hoag Dr",
            "address_purpose": "LOCATION",
            "city": "Salamanca",
            "state": "NY",
            "postal_code": "147791365",
            "country_code": "US",
            "telephone_number": "716-945-5894",
            "fax_number": "716-242-6345",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MEDER",
        "first_name": "KRISTEN",
        "middle_name": "A",
        "name_prefix": "Mrs.",
        "credential": "LMHC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-12-27",
        "last_updated": "2025-04-21",
        "certification_date": "2025-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NY",
            "license": "009514",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Irving, NY

Sources for this page

Verify at the official NPI Registry.