Southtowns Mental Health Counseling PC

Key facts

NPI

1306411244

Entity type

Organization (NPI type 2)

Primary specialty

Mental Health Counselor 101YM0800X

Legal business name

SOUTHTOWNS MENTAL HEALTH COUNSELING PC

Practice address

38 Lake St
Hamburg, NY 14075-4951

Phone

(716) 410-5390

Fax

(716) 422-9011

NPI assigned

May 24, 2021

Organization subpart

No

Authorized official

Name

Amanda Bolin, LMHC NPI 1295418911

Title

Director

Phone

(716) 410-5390

Authorized official NPPES reports the authorized official by name only; the link goes to the one practitioner connected to this organization with that name.

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Amanda Bolin, LMHC Mental Health Counselor · Hamburg, NY · NPI 1295418911
  Medicare reassignment NPD Authorized official MENTAL HEALTH · NY
• Tammy Lynn Bissonnette, MA, LMHC, CASAC, QHP Mental Health Counselor · Hamburg, NY · NPI 1255195145
  Medicare reassignment NPD MENTAL HEALTH · NY
• Kristen Lynn Corbran Counselor · Orchard Park, NY · NPI 1437656428
  Medicare reassignment NPD NY
• Jason Shear, LMHC-P Mental Health Counselor · Hamburg, NY · NPI 1386189496
  Medicare reassignment NPD MENTAL HEALTH · NY
• Shelly Harris, RN Registered Nurse · Hamburg, NY · NPI 1487328860
  NPD REGISTERED NURSE
• Michael Edward Godzala III, MD Psychiatry Physician · Buffalo, NY · NPI 1215170030
  NPD (past)

Medicare participation

Medicare fee-for-service enrollment

Enrolled in NY

Medicare enrollment records

National Provider Directory

Locations

Specialties & licenses

Addresses

Other identifiers

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Feb 10, 2026.

{
    "created_epoch": "1621814400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1770681600000",
    "number": "1306411244",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "38 LAKE ST",
            "city": "HAMBURG",
            "state": "NY",
            "postal_code": "140754951",
            "telephone_number": "716-410-5390",
            "fax_number": "716-422-9011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "38 LAKE ST",
            "city": "HAMBURG",
            "state": "NY",
            "postal_code": "140754951",
            "telephone_number": "716-410-5390",
            "fax_number": "716-422-9011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHTOWNS MENTAL HEALTH COUNSELING PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-05-24",
        "last_updated": "2026-02-10",
        "certification_date": "2026-02-10",
        "status": "A",
        "authorized_official_last_name": "BOLIN",
        "authorized_official_first_name": "AMANDA",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "716-410-5390",
        "authorized_official_credential": "LMHC"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Registered Nurse",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "163WP0808X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "07665974",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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All providers in Hamburg, NY · Mental Health Counselor in New York