Individual provider Active NPI

Nanette Eddy, LMHC

  • Mental Health Counselor
  • Burnt Hills, NY
National Provider Identifier
1235680737
Registry record updated Nov 29, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
088667 Issued in NY
Practice address
333 Kingsley Rd
Burnt Hills, NY 12027-9509
Phone
(518) 791-4491
NPI assigned
Oct 19, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 29, 2018

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 088667 NY Primary

Addresses

Primary practice location

333 Kingsley Rd
Burnt Hills, NY 12027-9509

Mailing address

24 Crooked St
Ballston Lake, NY 12019-2622
Phone (518) 791-4491

Other practice location 1

11-21 Broadway St
Gloversville, NY 12078-3968
Phone (518) 725-4310 ext. 125

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.
Opted out of Medicare
Previously, effective Sep 10, 2024 through Sep 10, 2026

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
088667NYMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1476835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1543449600000",
    "number": "1235680737",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24 CROOKED ST",
            "city": "BALLSTON LAKE",
            "state": "NY",
            "postal_code": "120192622",
            "telephone_number": "518-791-4491"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "333 KINGSLEY RD",
            "city": "BURNT HILLS",
            "state": "NY",
            "postal_code": "120279509",
            "telephone_number": "518-791-4491"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11-21 Broadway St",
            "address_purpose": "LOCATION",
            "city": "Gloversville",
            "state": "NY",
            "postal_code": "120783968",
            "country_code": "US",
            "telephone_number": "518-725-4310 x125",
            "fax_number": "518-725-2556",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "EDDY",
        "first_name": "NANETTE",
        "credential": "LMHC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-10-19",
        "last_updated": "2018-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NY",
            "license": "088667",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Burnt Hills, NY

Sources for this page

Verify at the official NPI Registry.