Madonna Adymy, LCAT, ATR-BC
Individual provider Active NPI Counselor · Buffalo, NY
NPI 1457746174 · NPPES record last updated Jun 21, 2022
Key facts
- NPI
- 1457746174
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Counselor 101Y00000X
- License
- 002057 (NY)
- Practice address
- 19 Hopkins Rd
Buffalo, NY 14221-4641 - Phone
- (716) 539-5255
- NPI assigned
- Mar 31, 2015
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
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 |
|---|---|---|---|
| 19-210 | NY | MD | Counselor |
| 002057 | NY | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Illuminate NP Psychiatry | Past | Accepting new patients | |
| Bestself Behavioral Health, Inc. | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | 002057 | NY | Yes |
| Counselor | 101Y00000X | 19-210 | NY |
Addresses
Primary practice location
19 Hopkins Rd
Buffalo, NY 14221-4641
Mailing address
19 Hopkins Rd
Buffalo, NY 14221-4641
Phone (716) 539-5255
Other providers in Buffalo, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 21, 2022. 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.