Individual provider Active NPI

Christa Coffey

  • Mental Health Counselor
  • Clifton Springs, NY
National Provider Identifier
1396284832
Registry record updated Feb 16, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
2 Coulter Rd
Clifton Springs, NY 14432-1122
Phone
(315) 462-1050
NPI assigned
Feb 16, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 16, 2017

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 Primary

Addresses

Primary practice location

2 Coulter Rd
Clifton Springs, NY 14432-1122

Mailing address

2 Coulter Rd
Clifton Springs, NY 14432-1122

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
I20250331000280 NY Practitioner - Mental Health Counselor 8921521022 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
003295NYMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Professional Medical Concierge Services, PLLC Mental Health CurrentSince Jan 23, 2025 Accepting new patients

Locations

1785 Route 9
Halfmoon, NY 12065
Phone (518) 238-6028

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1487203200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1487203200000",
    "number": "1396284832",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 COULTER RD",
            "city": "CLIFTON SPRINGS",
            "state": "NY",
            "postal_code": "144321122"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 COULTER RD",
            "city": "CLIFTON SPRINGS",
            "state": "NY",
            "postal_code": "144321122",
            "telephone_number": "315-462-1050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COFFEY",
        "first_name": "CHRISTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-02-16",
        "last_updated": "2017-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clifton Springs, NY

Sources for this page

Verify at the official NPI Registry.