NPIMap

Organization Active NPI

Cayuga Counseling Services Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Auburn, NY
National Provider Identifier
1194874610
Registry record updated Apr 28, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
License
7734100A Issued in NY
Legal business name
CAYUGA COUNSELING SERVICES INC
Practice address
17 East Genesee St
Auburn, NY 13021
Phone
(315) 253-9795
Fax
(315) 253-3255
NPI assigned
Jan 10, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 28, 2016

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

Authorized official

Name
Heather Petrus, LMHCNPI 1518024512
Title
Executive Director
Phone
(315) 253-9795

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X 7734100A NY Primary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X 7734430 NY
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X 7734100B NY
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X 7734100C NY
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X 7734300A NY

Addresses

Primary practice location

17 East Genesee St
Auburn, NY 13021

Mailing address

17 East Genesee St
Auburn, NY 13021
Phone (315) 253-9795

Other identifiers 1

IdentifierTypeStateIssuer
01014075MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050502000738 NY Part B Supplier - Clinic/Group Practice 5890734537 Receives reassigned benefits from 10 practitioners
Practice locations: Auburn, NY

National Provider Directory

National Provider Directory
Tax ID family
Cayuga Counseling Services2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

17 E Genesee St
Auburn, NY 13021
Phone (315) 253-9795

17 E Genesee St
Fl 2
Auburn, NY 13021
Phone (315) 253-9795

Practitioners & affiliated clinicians

Practitioners 19

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 19

NPI Registry JSON

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

{
    "created_epoch": "1168387200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1461801600000",
    "number": "1194874610",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17 EAST GENESEE ST",
            "city": "AUBURN",
            "state": "NY",
            "postal_code": "13021",
            "telephone_number": "315-253-9795",
            "fax_number": "315-253-3255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17 EAST GENESEE ST",
            "city": "AUBURN",
            "state": "NY",
            "postal_code": "13021",
            "telephone_number": "315-253-9795",
            "fax_number": "315-253-3255"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAYUGA COUNSELING SERVICES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-10",
        "last_updated": "2016-04-28",
        "status": "A",
        "authorized_official_last_name": "PETRUS",
        "authorized_official_first_name": "HEATHER",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "315-253-9795",
        "authorized_official_credential": "LMHC"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "NY",
            "license": "7734100A",
            "primary": true
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "NY",
            "license": "7734430",
            "primary": false
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "NY",
            "license": "7734100B",
            "primary": false
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "NY",
            "license": "7734100C",
            "primary": false
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "NY",
            "license": "7734300A",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01014075",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Auburn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.