Individual provider Active NPI

Brooke Rachel Kaczmarek, MA

  • Mental Health Counselor
  • Batavia, NY
National Provider Identifier
1316417280
Registry record updated Jan 3, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
P14396 Issued in NY
Practice address
5130 E Main Street Rd Ste 2
Batavia, NY 14020-3444
Phone
(585) 344-1421
NPI assigned
Dec 4, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 3, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X
Mental Health Counselor 101YM0800X P14396 NY Primary

Addresses

Primary practice location

5130 E Main Street Rd Ste 2
Batavia, NY 14020-3444

Mailing address

5130 E Main Street Rd Ste 2
Batavia, NY 14020-3444
Phone (585) 344-1421

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
P14396NYMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
County of Genesee County Treasurer Past Accepting new patients
County of Genesee County Treasurer PastSince Mar 2, 1998 Accepting new patients

Organizations & group practices 2

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": "1543881600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1546473600000",
    "number": "1316417280",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5130 E MAIN STREET RD STE 2",
            "city": "BATAVIA",
            "state": "NY",
            "postal_code": "140203444",
            "telephone_number": "585-344-1421"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5130 E MAIN STREET RD STE 2",
            "city": "BATAVIA",
            "state": "NY",
            "postal_code": "140203444",
            "telephone_number": "585-344-1421"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KACZMAREK",
        "first_name": "BROOKE",
        "middle_name": "RACHEL",
        "credential": "MA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-12-04",
        "last_updated": "2019-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NY",
            "license": "P14396",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Batavia, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.