Maryellen Carlucci

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

F405890-01 Issued in NY

Practice address

107 Institute St
Jamestown, NY 14701-6628

Phone

(716) 294-3995

Fax

(833) 974-2031

NPI assigned

Mar 13, 2026

Last updated

Mar 13, 2026By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1773360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773360000000",
    "number": "1528915907",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6386 TRANSIT RD APT 348",
            "city": "DEPEW",
            "state": "NY",
            "postal_code": "140431125",
            "telephone_number": "716-294-3995",
            "fax_number": "833-974-2031"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 INSTITUTE ST",
            "city": "JAMESTOWN",
            "state": "NY",
            "postal_code": "147016628",
            "telephone_number": "716-294-3995",
            "fax_number": "833-974-2031"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARLUCCI",
        "first_name": "MARYELLEN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2026-03-13",
        "last_updated": "2026-03-13",
        "certification_date": "2026-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NY",
            "license": "F405890-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Erin Carlson
• Heather Elizabeth Carlson
• Lyndsey Marie Carlson, RPA-C
• Michelle Carlson
• Trisha M Carlson, NP
• Brendan Carter, PTA
• Charlene Swift Carter, NP
• Toni L Castiglia
• Javier Castro-Villeda
• Beverly Arlene Cavness, R.N.

• Psychiatric/Mental Health Nurse Practitioner in Jamestown, NY
• Providers in Jamestown, NY by specialty
• Psychiatric/Mental Health Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.