Individual provider Active NPI

Maureen Jennifer Privatera, LMHC

  • Mental Health Counselor
  • Le Roy, NY
National Provider Identifier
1306227194
Registry record updated Nov 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
7753 Issued in NY
Practice address
106 Munson Street
Leroy, NY 14482
Phone
(585) 768-4655
Fax
(585) 768-4655
NPI assigned
Jun 17, 2015
Last updated
Nov 1, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 1, 2023

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 7753 NY Primary

Addresses

Primary practice location

106 Munson Street
Leroy, NY 14482

Mailing address

3 West Ave
Le Roy, NY 14482-1381
Phone (585) 768-4655

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
I20260331000539 NY Practitioner - Mental Health Counselor 7416432257 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2015
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

106 Munson St
Le Roy, NY 14482-8933

PO Box
Suite 130
Le Roy, NY 14482

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
7753NYMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Village Mental Health Counseling PLLC Mental Health CurrentSince Nov 5, 2023 Accepting new patients

Locations

3 West Ave
Le Roy, NY 14482
Phone (585) 224-5179

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, 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": "1434499200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698796800000",
    "number": "1306227194",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 WEST AVE",
            "city": "LE ROY",
            "state": "NY",
            "postal_code": "144821381",
            "telephone_number": "585-768-4655",
            "fax_number": "585-768-4655"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "106 MUNSON STREET",
            "city": "LEROY",
            "state": "NY",
            "postal_code": "14482",
            "telephone_number": "585-768-4655",
            "fax_number": "585-768-4655"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRIVATERA",
        "first_name": "MAUREEN",
        "middle_name": "JENNIFER",
        "credential": "LMHC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-06-17",
        "last_updated": "2023-11-01",
        "certification_date": "2023-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NY",
            "license": "7753",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Le Roy, NY

Sources for this page

Verify at the official NPI Registry.