Individual provider Active NPI

Nicole Jennifer Yager, MHC

  • Counselor
  • Lyons, NY
National Provider Identifier
1255463261
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
License
P54282 Issued in NY
Practice address
Wayne Behavioral Heatlh Network
1519 Nye Road
Lyons, NY 14489
Phone
(315) 946-5722
Fax
(315) 946-7066
NPI assigned
Mar 12, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X P54282 NY Primary

Addresses

Primary practice location

Wayne Behavioral Heatlh Network
1519 Nye Road
Lyons, NY 14489

Mailing address

1692 Ridge Rd
Ontario, NJ 14519
Phone (315) 524-2686

Other identifiers 1

IdentifierTypeStateIssuer
02249154MedicaidNY

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
I20250908003752 NY Practitioner - Mental Health Counselor 1052813011 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2017
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1519 Nye Rd
Suite 110
Lyons, NY 14489-9112

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
P54282NYMDCounselor

Practice roles

OrganizationSpecialtyStatusNew patients
County of Wayne CurrentSince Jun 13, 2025 Accepting new patients

Locations

1519 Nye Rd
Lyons, NY 14489
Phone (315) 946-5722

1519 Nye Rd
Ste 100
Lyons, NY 14489
Phone (315) 946-5722

1519 Nye Rd
Ste 110
Lyons, NY 14489
Phone (315) 946-5722

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1173657600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1255463261",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1692 RIDGE RD",
            "city": "ONTARIO",
            "state": "NJ",
            "postal_code": "14519",
            "telephone_number": "315-524-2686"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "WAYNE BEHAVIORAL HEATLH NETWORK",
            "address_2": "1519 NYE ROAD",
            "city": "LYONS",
            "state": "NY",
            "postal_code": "14489",
            "telephone_number": "315-946-5722",
            "fax_number": "315-946-7066"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YAGER",
        "first_name": "NICOLE",
        "middle_name": "JENNIFER",
        "name_prefix": "Ms.",
        "credential": "MHC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "NY",
            "license": "P54282",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02249154",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lyons, NY

Sources for this page

Verify at the official NPI Registry.