Individual provider Active NPI

Emily Rose Tedd, LMHC

  • Mental Health Counselor
  • Syracuse, NY
National Provider Identifier
1366139503
Registry record updated Jul 15, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
015057 Issued in NY
Practice address
1045 James St Ste 100
Syracuse, NY 13203-2758
Phone
(315) 425-1004
NPI assigned
Apr 19, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2026

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 015057 NY Primary

Addresses

Primary practice location

1045 James St Ste 100
Syracuse, NY 13203-2758

Mailing address

1045 James St Ste 100
Syracuse, NY 13203-2758
Phone (315) 425-1004

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250703001418 NY Practitioner - Mental Health Counselor 1254844020 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
015057NYMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Liberty Resources Inc. Current Accepting new patients
Liberty Resources, Inc. CurrentSince Aug 1, 2025 Accepting new patients
Liberty Resources, Inc. CurrentSince Aug 1, 2025 Accepting new patients

Locations

1045 James St
Ste 100
Syracuse, NY 13203
Phone (315) 425-1004

1045 James St
Syracuse, NY 13203
Phone (315) 425-1004

Interoperability endpoints

  • Direct secure messaging: emily.crouse.p1@direct.liberty-resources.nextgenshare.com

Organizations & group practices 3

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": "1681862400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1784073600000",
    "number": "1366139503",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1045 JAMES ST STE 100",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132032758",
            "telephone_number": "315-425-1004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1045 JAMES ST STE 100",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132032758",
            "telephone_number": "315-425-1004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TEDD",
        "first_name": "EMILY",
        "middle_name": "ROSE",
        "credential": "LMHC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-04-19",
        "last_updated": "2026-07-15",
        "certification_date": "2026-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NY",
            "license": "015057",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Syracuse, NY

Sources for this page

Verify at the official NPI Registry.