Active NPI
Jonathan R Carlson
- Mental Health Counselor
- Warsaw, NY
National Provider Identifier
1326534603
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 11932
- Practice address
- 34 N Main St
Warsaw, NY 14569-1326 - Phone
- (585) 786-0220
- Fax
- (585) 786-3631
- NPI assigned
- Jul 10, 2018
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 11932 | NY | Primary |
Addresses
Primary practice location
34 N Main St
Warsaw, NY 14569-1326
Mailing address
227 Thorn Ave
Orchard Park, NY 14127-2600
Phone (716) 662-2040
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11932 | NY | MD | Addiction (Substance Use Disorder) Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1531180800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1649289600000",
"number": "1326534603",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "227 THORN AVE",
"city": "ORCHARD PARK",
"state": "NY",
"postal_code": "141272600",
"telephone_number": "716-662-2040"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "34 N MAIN ST",
"city": "WARSAW",
"state": "NY",
"postal_code": "145691326",
"telephone_number": "585-786-0220",
"fax_number": "585-786-3631"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CARLSON",
"first_name": "JONATHAN",
"middle_name": "R",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-07-10",
"last_updated": "2022-04-07",
"certification_date": "2022-04-07",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "NY",
"license": "11932",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Warsaw, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.