Individual provider Active NPI

Duquinha Thompson

  • Mental Health Counselor
  • Syracuse, NY
National Provider Identifier
1194909242
Registry record updated Sep 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
013731 Issued in NY
Practice address
719 Harrison St
Syracuse, NY 13210-2695
Phone
(315) 464-5540
NPI assigned
Dec 26, 2007
Last updated
Sep 21, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 21, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 013731 NY Primary
Developmental Therapist 222Q00000X S63735861 MA

Addresses

Primary practice location

719 Harrison St
Syracuse, NY 13210-2695

Mailing address

1308 Cumberland Ave
Syracuse, NY 13210-3417
Phone (617) 990-7422

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
I20240531001856 NY Practitioner - Mental Health Counselor 9537501887 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
S63735861MAMDDevelopmental Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Push4Purpose Mental Health CurrentSince Sep 21, 2025 Accepting new patients
Psychiatry Faculty Practice, Inc. CurrentSince Sep 24, 2023 Accepting new patients

Locations

719 Harrison St
Syracuse, NY 13210
Phone (315) 464-3265

Interoperability endpoints

  • Direct secure messaging: duquinha.thompson.p1@direct.liberty-resources.nextgenshare.com

Organizations & group practices 5

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": "1198627200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695254400000",
    "number": "1194909242",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1308 CUMBERLAND AVE",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132103417",
            "telephone_number": "617-990-7422"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "719 HARRISON ST",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132102695",
            "telephone_number": "315-464-5540"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMPSON",
        "first_name": "DUQUINHA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-12-26",
        "last_updated": "2023-09-21",
        "certification_date": "2023-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NY",
            "license": "013731",
            "primary": true
        },
        {
            "code": "222Q00000X",
            "taxonomy_group": "",
            "desc": "Developmental Therapist",
            "state": "MA",
            "license": "S63735861",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Syracuse, NY

Sources for this page

Verify at the official NPI Registry.