Jaclyn Abbott
Individual provider Active NPI Mental Health Counselor · Syracuse, NY
NPI 1447865613 · NPPES record last updated Sep 14, 2020
Key facts
- NPI
- 1447865613
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Mental Health Counselor 101YM0800X
- License
- 02249154 (NY)
- Practice address
- 321 W Onondaga St
Syracuse, NY 13202-3207 - Phone
- (315) 478-2030
- NPI assigned
- Sep 14, 2020
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 02249154 | NY | MD | Mental Health Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Central New York Services, Inc. | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 02249154 | NY | Yes |
Addresses
Primary practice location
321 W Onondaga St
Syracuse, NY 13202-3207
Mailing address
321 W Onondaga St
Syracuse, NY 13202-3207
Phone (315) 478-2030
Other providers in Syracuse, NY
- Pamela Abbamont
- Ahmed Abbas
- Muna Abbas
- Roanna L Abborino
- Donna Kaye Abbott
- Leia Abbott
- Melinda Abbott
- Summer Abbott
- Elias S. Abboud
- Omar Abdallah
All providers in Syracuse, NY · Mental Health Counselor in New York
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 14, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.