Individual provider Active NPI

Heather Watt Odum, LMHC

  • Mental Health Counselor
  • Lockport, NY
National Provider Identifier
1336412196
Registry record updated Mar 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
005936-01 Issued in NY
Practice address
33 Ontario St
Lockport, NY 14094-2815
Phone
(716) 433-1937
Fax
(716) 433-1961
NPI assigned
Feb 9, 2012
Last updated
Mar 12, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 12, 2022

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 005936-01 NY Primary

Addresses

Primary practice location

33 Ontario St
Lockport, NY 14094-2815

Mailing address

33 Ontario St
Lockport, NY 14094-2815
Phone (716) 433-1937

Other names 1

  • Heather E Watt Former name

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

LicenseStateTypeSpecialty
005936-01NYMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
The Dale Association, Inc. Mental Health CurrentSince Mar 20, 2022 Accepting new patients
Horizon Healthservices Past Accepting new patients

Locations

33 Ontario St
Lockport, NY 14094
Phone (716) 433-1937

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, 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": "1328745600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1647043200000",
    "number": "1336412196",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "33 ONTARIO ST",
            "city": "LOCKPORT",
            "state": "NY",
            "postal_code": "140942815",
            "telephone_number": "716-433-1937",
            "fax_number": "716-433-1961"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "33 ONTARIO ST",
            "city": "LOCKPORT",
            "state": "NY",
            "postal_code": "140942815",
            "telephone_number": "716-433-1937",
            "fax_number": "716-433-1961"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ODUM",
        "first_name": "HEATHER",
        "middle_name": "WATT",
        "credential": "LMHC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-02-09",
        "last_updated": "2022-03-12",
        "certification_date": "2022-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NY",
            "license": "005936-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "HEATHER",
            "last_name": "WATT",
            "middle_name": "E",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Lockport, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 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.

Verify at the official NPI Registry.