Individual provider Active NPI

Libby Tomasulo

  • Mental Health Counselor
  • Buffalo, NY
National Provider Identifier
1164916920
Registry record updated Jun 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
1131 Broadway St
Buffalo, NY 14212-1501
Phone
(716) 896-7350
NPI assigned
Jun 15, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 20, 2022

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 Primary

Addresses

Primary practice location

1131 Broadway St
Buffalo, NY 14212-1501

Mailing address

1131 Broadway St
Buffalo, NY 14212-1501
Phone (716) 896-7350

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
I20240418000545 NY Practitioner - Mental Health Counselor 7012356405 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mid-Erie Mental Health Services IncGroup PAC ID 5496707945, 33 clinicians

Practice addresses (Care Compare)

1526 Walden Ave
Cheektowaga, NY 14225-4985
Phone (716) 895-7167

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Mid Erie Mental Health Services Inc CurrentSince Feb 28, 2024 Accepting new patients
Mid Erie Past Accepting new patients

Locations

1526 Walden Ave
Ste 400
Cheektowaga, NY 14225
Phone (716) 895-7167

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1529020800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655683200000",
    "number": "1164916920",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1131 BROADWAY ST",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142121501",
            "telephone_number": "716-896-7350"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1131 BROADWAY ST",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142121501",
            "telephone_number": "716-896-7350"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TOMASULO",
        "first_name": "LIBBY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-15",
        "last_updated": "2022-06-20",
        "certification_date": "2022-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Buffalo, NY

Sources for this page

Verify at the official NPI Registry.