Individual provider Active NPI

Laurie Jean Coreno -Reynolds, LMHC

  • Mental Health Counselor
  • Clifton Park, NY
National Provider Identifier
1154684017
Registry record updated Jun 16, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
0000-41 Issued in NY
Practice address
636 Plank Rd Ste 111
Clifton Park, NY 12065-2042
Phone
(518) 383-3356
Fax
(518) 371-9936
NPI assigned
Jun 16, 2012
Last updated
Jun 16, 2012By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 16, 2012

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 0000-41 NY Primary

Addresses

Primary practice location

636 Plank Rd Ste 111
Clifton Park, NY 12065-2042

Mailing address

636 Plank Rd Ste 111
Clifton Park, NY 12065-2042
Phone (518) 383-3356

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
I20240112003725 NY Practitioner - Mental Health Counselor 2062863152 Practice locations: Clifton Park, NY

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0000-41NYMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Ronald Otwori NP in Psychiatry PLLC Mental Health PastSince May 26, 2024 Accepting new patients

Organizations & group practices 1

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": "1339804800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1339804800000",
    "number": "1154684017",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "636 PLANK RD STE 111",
            "city": "CLIFTON PARK",
            "state": "NY",
            "postal_code": "120652042",
            "telephone_number": "518-383-3356",
            "fax_number": "518-371-9936"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "636 PLANK RD STE 111",
            "city": "CLIFTON PARK",
            "state": "NY",
            "postal_code": "120652042",
            "telephone_number": "518-383-3356",
            "fax_number": "518-371-9936"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORENO -REYNOLDS",
        "first_name": "LAURIE",
        "middle_name": "JEAN",
        "name_prefix": "Ms.",
        "credential": "LMHC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-06-16",
        "last_updated": "2012-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NY",
            "license": "0000-41",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clifton Park, NY

Sources for this page

Verify at the official NPI Registry.