Individual provider Active NPI

Karen Marie Wolchetsky, RN

  • Addiction (Substance Use Disorder) Counselor
  • Ithaca, NY
National Provider Identifier
1154653889
Registry record updated Feb 5, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
484936-1 Issued in NY
Practice address
201 E Green St
5TH FL.
Ithaca, NY 14850-5635
Phone
(607) 274-6288
Fax
(607) 274-6280
NPI assigned
Feb 5, 2010
Last updated
Feb 5, 2010By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 5, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 484936-1 NY Primary

Addresses

Primary practice location

201 E Green St
5TH FL.
Ithaca, NY 14850-5635

Mailing address

201 E. Green St. 5TH FL.
Alcohol and Drug Council of Tompkins County
Ithaca, NY 14850-5635
Phone (607) 274-6288

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
484936-1NYMDAddiction (Substance Use Disorder) Counselor

NPI Registry JSON

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

{
    "created_epoch": "1265328000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1265328000000",
    "number": "1154653889",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 E. GREEN ST. 5TH FL.",
            "address_2": "ALCOHOL AND DRUG COUNCIL OF TOMPKINS COUNTY",
            "city": "ITHACA",
            "state": "NY",
            "postal_code": "148505635",
            "telephone_number": "607-274-6288",
            "fax_number": "607-274-6280"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 E GREEN ST",
            "address_2": "5TH FL.",
            "city": "ITHACA",
            "state": "NY",
            "postal_code": "148505635",
            "telephone_number": "607-274-6288",
            "fax_number": "607-274-6280"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOLCHETSKY",
        "first_name": "KAREN",
        "middle_name": "MARIE",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-02-05",
        "last_updated": "2010-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NY",
            "license": "484936-1",
            "primary": true
        }
    ],
    "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 Feb 5, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.