Active NPI
Sue Ellen Rapp, LCSW
- Mental Health Counselor
- Vestal, NY
National Provider Identifier
1215096300
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- R037230-1
- Practice address
- 300 Main St
Vestal, NY 13850-1545 - Phone
- (607) 754-2587
- NPI assigned
- Dec 6, 2006
- Last updated
- Jul 8, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | R037230-1 | NY | Primary |
Addresses
Primary practice location
300 Main St
Vestal, NY 13850-1545
Mailing address
248 Noyes Rd
Vestal, NY 13850-5616
Phone (607) 754-2587
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Nov 14, 2022 through Nov 14, 2026
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R037230-1 | NY | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1165363200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1215096300",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "248 NOYES RD",
"city": "VESTAL",
"state": "NY",
"postal_code": "138505616",
"telephone_number": "607-754-2587"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "300 MAIN ST",
"city": "VESTAL",
"state": "NY",
"postal_code": "138501545",
"telephone_number": "607-754-2587"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RAPP",
"first_name": "SUE",
"middle_name": "ELLEN",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-12-06",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "NY",
"license": "R037230-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Vestal, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.