Individual provider Active NPI

Melissa Fuka, LMSW

  • Addiction (Substance Use Disorder) Counselor
  • Ithaca, NY
National Provider Identifier
1487964763
Registry record updated Nov 2, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
079789-1 Issued in NY
Practice address
334 W State St
Ithaca, NY 14850-5432
Phone
(607) 273-5500
Fax
(607) 273-1277
NPI assigned
Oct 20, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 2, 2010

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 079789-1 NY Primary

Addresses

Primary practice location

334 W State St
Ithaca, NY 14850-5432

Mailing address

334 W State St
PO Box 789
Ithaca, NY 14850-5432
Phone (607) 273-5500

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
079789-1NYMDAddiction (Substance Use Disorder) Counselor

NPI Registry JSON

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

{
    "created_epoch": "1287532800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1288656000000",
    "number": "1487964763",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "334 W STATE ST",
            "address_2": "PO BOX 789",
            "city": "ITHACA",
            "state": "NY",
            "postal_code": "148505432",
            "telephone_number": "607-273-5500",
            "fax_number": "607-273-1277"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "334 W STATE ST",
            "city": "ITHACA",
            "state": "NY",
            "postal_code": "148505432",
            "telephone_number": "607-273-5500",
            "fax_number": "607-273-1277"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FUKA",
        "first_name": "MELISSA",
        "credential": "LMSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-10-20",
        "last_updated": "2010-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NY",
            "license": "079789-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ithaca, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.