Individual provider Active NPI

Kristin L Tripp, LMHC

  • Mental Health Counselor
  • Syracuse, NY
National Provider Identifier
1518337328
Registry record updated Oct 6, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
006729-1 Issued in NY
Practice address
1045 James St
Syracuse, NY 13203-2730
Phone
(315) 472-4471
Fax
(315) 422-4855
NPI assigned
Oct 6, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 6, 2015

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 006729-1 NY Primary

Addresses

Primary practice location

1045 James St
Syracuse, NY 13203-2730

Mailing address

1045 James St
Syracuse, NY 13203-2730

Other identifiers 1

IdentifierTypeStateIssuer
16-1129675MedicaidNY

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
I20250402003376 NY Practitioner - Mental Health Counselor 1658894399 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Professional Medical Concierge Services PLLCGroup PAC ID 0840614020, 75 clinicians

Practice addresses (Care Compare)

1785 Route 9
Halfmoon, NY 12065-2449
Phone (518) 238-6028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
006729-1NYMDOccupational Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Professional Medical Concierge Services, PLLC Mental Health CurrentSince Jan 23, 2025 Accepting new patients

Locations

1785 Route 9
Halfmoon, NY 12065
Phone (518) 238-6028

Organizations & group practices 1

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": "1444089600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1444089600000",
    "number": "1518337328",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1045 JAMES ST",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132032730"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1045 JAMES ST",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132032730",
            "telephone_number": "315-472-4471",
            "fax_number": "315-422-4855"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRIPP",
        "first_name": "KRISTIN",
        "middle_name": "L",
        "name_prefix": "Mrs.",
        "credential": "LMHC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-10-06",
        "last_updated": "2015-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NY",
            "license": "006729-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "16-1129675",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Syracuse, NY

Sources for this page

Verify at the official NPI Registry.