Individual provider Active NPI

Gabriella Avery

  • Mental Health Counselor
  • Syracuse, NY
National Provider Identifier
1447985262
Registry record updated Apr 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
014548 Issued in NY
Practice address
635 James St Ste 1
Syracuse, NY 13203-2661
Phone
(315) 472-3171
NPI assigned
Jul 18, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 3, 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 014548 NY Primary

Addresses

Primary practice location

635 James St Ste 1
Syracuse, NY 13203-2661

Mailing address

600 Ivy Ridge Rd Apt 30
Syracuse, NY 13210-4113

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
I20240906001835 NY Practitioner - Mental Health Counselor 5395285241 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Psychiatry Services of New York, PCGroup PAC ID 9133534340, 34 clinicians

Practice addresses (Care Compare)

3300 James St
Suite 100
Syracuse, NY 13206-2392
Phone (315) 422-0300

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Psychiatry Services of New York PC CurrentSince Jun 29, 2024 Accepting new patients
Psychiatry Services of New York, P.C. CurrentSince Jun 29, 2024 Accepting new patients

Locations

8289 Loop Rd
Baldwinsville, NY 13027
Phone (315) 452-0300

3300 James St
Ste 201
Syracuse, NY 13206
Phone (315) 437-4500

3300 James St
Ste 101
Syracuse, NY 13206

3300 James St
Ste 100
Syracuse, NY 13206

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/28623/brand/6/csg/1/fhir/r4

Organizations & group practices 2

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": "1658102400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712102400000",
    "number": "1447985262",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 IVY RIDGE RD APT 30",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132104113"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "635 JAMES ST STE 1",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132032661",
            "telephone_number": "315-472-3171"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AVERY",
        "first_name": "GABRIELLA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-07-18",
        "last_updated": "2024-04-03",
        "certification_date": "2024-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NY",
            "license": "014548",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Syracuse, NY

Sources for this page

Verify at the official NPI Registry.