Michelle Lynn Nitschke

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

003231 Issued in NY

Practice address

200 Mullin St
Watertown, NY 13601-4194

Phone

(315) 782-4483

NPI assigned

Jun 4, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Jul 22, 2024 through Jul 22, 2028

Medicare enrollment (NPD)

Not enrolled

Practice roles

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.

• Family Counseling Service of Nny, Inc.

  • Counselor
  • Watertown, NY
  • NPI 1679660989
  NPD (past)

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

{
    "created_epoch": "1559606400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1559606400000",
    "number": "1508424573",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 MULLIN ST",
            "city": "WATERTOWN",
            "state": "NY",
            "postal_code": "136014194",
            "telephone_number": "315-782-4483"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 MULLIN ST",
            "city": "WATERTOWN",
            "state": "NY",
            "postal_code": "136014194",
            "telephone_number": "315-782-4483"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NITSCHKE",
        "first_name": "MICHELLE",
        "middle_name": "LYNN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-04",
        "last_updated": "2019-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NY",
            "license": "003231",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INSURANCE",
            "identifier": "003231",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rachel Ruth Newvine, RN
• Natalie Nielsen, M.D.
• William J Niewieroski Jr., CRNA
• Jordan C Nigro, CRNA
• Michele L Nikitich, MS, OTR/L
• Nny Senior Services, Inc
• Katie Noble
• Jessie Noordyk, MS CCC-SLP
• North Country Allergy and Immunology Associates PC
• North Country Counseling Services LLC

• Mental Health Counselor in Watertown, NY
• Providers in Watertown, NY by specialty
• Mental Health Counselor in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2019; 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.

Verify at the official NPI Registry.