Individual provider Active NPI

Carlyanna M Wells, MS, LMHC

  • Mental Health Counselor
  • Oswego, NY
National Provider Identifier
1396572152
Registry record updated Sep 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
015105-01 Issued in NY
Practice address
5 W Cayuga St
Oswego, NY 13126-2031
Phone
(315) 342-9255
NPI assigned
Sep 16, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2024

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 015105-01 NY Primary

Addresses

Primary practice location

5 W Cayuga St
Oswego, NY 13126-2031

Mailing address

5 W Cayuga St
Oswego, NY 13126-2031
Phone (315) 342-9255

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Oct 3, 2024 through Oct 3, 2026

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
015105-01NYMDMental Health Counselor
015105NYMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Integrative Mental Health Counseling Services, PLLC Mental Health PastSince Sep 23, 2024 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1726444800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726444800000",
    "number": "1396572152",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 W CAYUGA ST",
            "city": "OSWEGO",
            "state": "NY",
            "postal_code": "131262031",
            "telephone_number": "315-342-9255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 W CAYUGA ST",
            "city": "OSWEGO",
            "state": "NY",
            "postal_code": "131262031",
            "telephone_number": "315-342-9255"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WELLS",
        "first_name": "CARLYANNA",
        "middle_name": "M",
        "name_prefix": "Ms.",
        "credential": "MS, LMHC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-09-16",
        "last_updated": "2024-09-16",
        "certification_date": "2024-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NY",
            "license": "015105-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oswego, NY

Sources for this page

Verify at the official NPI Registry.