Individual provider Active NPI

Staceyann Reid, LMHC

  • Mental Health Counselor
  • Syracuse, NY
National Provider Identifier
1376182881
Registry record updated Apr 7, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
010043 Issued in NY
Practice address
719 Harrison St
Syracuse, NY 13210-2695
Phone
(315) 464-3265
Fax
(315) 464-3282
NPI assigned
Dec 31, 2019
Last updated
Apr 7, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 7, 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 010043 NY Primary

Addresses

Primary practice location

719 Harrison St
Syracuse, NY 13210-2695

Mailing address

719 Harrison St
Syracuse, NY 13210-2695
Phone (315) 464-3265

Other practice location 1

913 Old Liverpool Rd
Liverpool, NY 13088-5757
Phone (315) 238-2141

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
I20260508002765 NY Practitioner - Mental Health Counselor 1850869751 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2014
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

719 Harrison St
Syracuse, NY 13210-2695

750 E Adams St
Syracuse, NY 13210-2306

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
010043NYMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Psychiatry Faculty Practice, Inc. PastSince Aug 1, 2020 Accepting new patients

Organizations & group practices 1

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": "1577750400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1775520000000",
    "number": "1376182881",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "719 HARRISON ST",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132102695",
            "telephone_number": "315-464-3265",
            "fax_number": "315-464-3282"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "719 HARRISON ST",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132102695",
            "telephone_number": "315-464-3265",
            "fax_number": "315-464-3282"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "913 Old Liverpool Rd",
            "address_purpose": "LOCATION",
            "city": "Liverpool",
            "state": "NY",
            "postal_code": "130885757",
            "country_code": "US",
            "telephone_number": "315-238-2141",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "REID",
        "first_name": "STACEYANN",
        "credential": "LMHC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-12-31",
        "last_updated": "2026-04-07",
        "certification_date": "2026-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NY",
            "license": "010043",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Syracuse, NY

Sources for this page

Verify at the official NPI Registry.