Individual provider Active NPI

Cathleen Elizabeth Shea, LMHC

  • Mental Health Counselor
  • North Syracuse, NY
National Provider Identifier
1134970817
Registry record updated Mar 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
003611 Issued in NY
Practice address
7266 Buckley Rd
North Syracuse, NY 13212-2649
Phone
(315) 458-0919
NPI assigned
Mar 29, 2024
Last updated
Mar 29, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 29, 2024

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 003611 NY Primary

Addresses

Primary practice location

7266 Buckley Rd
North Syracuse, NY 13212-2649

Mailing address

9407 Hawkeye Dr
Brewerton, NY 13029-9514
Phone (315) 256-5932

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
I20240720000145 NY Practitioner - Mental Health Counselor 8022554534 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
003611NYMDAcupuncturist

Practice roles

OrganizationSpecialtyStatusNew patients
Bright Path Center, Inc. Mental Health CurrentSince Jun 18, 2024 Accepting new patients
Delconte Counseling LCSW PC Mental Health CurrentSince Mar 31, 2024 Accepting new patients

Locations

7266 Buckley Rd
Syracuse, NY 13212
Phone (315) 458-0919

Organizations & group practices 2

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": "1711670400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711670400000",
    "number": "1134970817",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9407 HAWKEYE DR",
            "city": "BREWERTON",
            "state": "NY",
            "postal_code": "130299514",
            "telephone_number": "315-256-5932"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7266 BUCKLEY RD",
            "city": "NORTH SYRACUSE",
            "state": "NY",
            "postal_code": "132122649",
            "telephone_number": "315-458-0919"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHEA",
        "first_name": "CATHLEEN",
        "middle_name": "ELIZABETH",
        "name_prefix": "Ms.",
        "credential": "LMHC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-03-29",
        "last_updated": "2024-03-29",
        "certification_date": "2024-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NY",
            "license": "003611",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Syracuse, NY

Sources for this page

Verify at the official NPI Registry.