Active NPI
Cynthia L Edmondson, LMHC
- Mental Health Counselor
- Wolcott, NY
National Provider Identifier
1457056103
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 013157
- Practice address
- 6282 High St
Wolcott, NY 14590-1005 - Phone
- (315) 532-7541
- NPI assigned
- Apr 3, 2023
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 013157 | NY | Primary |
Addresses
Primary practice location
6282 High St
Wolcott, NY 14590-1005
Mailing address
6282 High St
Wolcott, NY 14590-1005
Phone (315) 532-7541
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Jan 1, 2024 through Jan 1, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 013157 | NY | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1680480000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1680480000000",
"number": "1457056103",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6282 HIGH ST",
"city": "WOLCOTT",
"state": "NY",
"postal_code": "145901005",
"telephone_number": "315-532-7541"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6282 HIGH ST",
"city": "WOLCOTT",
"state": "NY",
"postal_code": "145901005",
"telephone_number": "315-532-7541"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EDMONDSON",
"first_name": "CYNTHIA",
"middle_name": "L",
"credential": "LMHC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2023-04-03",
"last_updated": "2023-04-03",
"certification_date": "2023-04-03",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "NY",
"license": "013157",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Wolcott, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.