Kasey Brenon, LMHC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

005968 Issued in NY

Practice address

188 S 3Rd St
Fulton, NY 13069-1801

Phone

(315) 207-5435

Fax

(315) 410-5544

NPI assigned

Apr 29, 2015

Last updated

Jun 11, 2019By 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

Other names 1

• Kasey Burke Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Mar 25, 2024 through Mar 25, 2028

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1430265600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560211200000",
    "number": "1326425273",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 WHITETAIL CIR",
            "city": "OSWEGO",
            "state": "NY",
            "postal_code": "131264157",
            "telephone_number": "315-529-7877",
            "fax_number": "315-410-5544"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "188 S 3RD ST",
            "city": "FULTON",
            "state": "NY",
            "postal_code": "130691801",
            "telephone_number": "315-207-5435",
            "fax_number": "315-410-5544"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRENON",
        "first_name": "KASEY",
        "credential": "LMHC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-04-29",
        "last_updated": "2019-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NY",
            "license": "005968",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KASEY",
            "last_name": "BURKE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Gary Douglas Bozeman, M.D.
• Michael Joseph Branish, RPH
• Rebekah June Braunlich, PHYSICIAN ASSISTANT
• Shannon E Brazill, M.S. CCC-SLP
• Danielle Breman, LMSW
• Cassandra Brown, RN,LENS PRACTITIONER
• Anthony Bryant, PMHNP
• Chanel Bryant, LMSW
• Matthew Scott Budreau, MS, MHC-LP
• Thomas Terry Bunker, D.D.S.

• Mental Health Counselor in Fulton, NY
• Providers in Fulton, 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 Jun 11, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.