Victoria Alisa Minick

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

012584 Issued in NY

Practice address

25 Willowbrook Rd
Queensbury, NY 12804-5882

Phone

(518) 926-7100

NPI assigned

Jul 18, 2022

Last updated

Jul 18, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Mental Health Counselor

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Che Senior Psychological Services, PCGroup PAC ID 8022905314, 227 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Che Senior Psychological Services, PC

  • Clinical Psychologist
  • Brooklyn, NY
  • NPI 1023078219
  Medicare reassignment Care Compare group NPD
• Knapp Street Psychiatry, PC

  • Clinical Psychologist
  • Brooklyn, NY
  • NPI 1043248776
  Medicare reassignment NPD

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

{
    "created_epoch": "1658102400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658102400000",
    "number": "1245965045",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "51 COUNTY ROUTE 76",
            "city": "STILLWATER",
            "state": "NY",
            "postal_code": "121701245",
            "telephone_number": "518-852-1294"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 WILLOWBROOK RD",
            "city": "QUEENSBURY",
            "state": "NY",
            "postal_code": "128045882",
            "telephone_number": "518-926-7100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MINICK",
        "first_name": "VICTORIA",
        "middle_name": "ALISA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-07-18",
        "last_updated": "2022-07-18",
        "certification_date": "2022-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NY",
            "license": "012584",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Patricia Middleton
• Jennifer Lee Miller, MS, CCC-SLP, TSSLD
• Scott C Miller, PA-C
• Lori Millis, PH.D.
• Gary Albert Mineconzo, O.D.
• Alexis M Mondella, NPP FNP
• Tammy Monroe, AUD
• Tarina Lee Monroe, MENTAL HEALTH COUNSE
• Susan J Montague, LMHC
• Bethany L Moon, M.A., S.S.P.

• Mental Health Counselor in Queensbury, NY
• Providers in Queensbury, NY by specialty
• Mental Health Counselor in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.