Individual provider Active NPI

Nemisis Negron

  • Mental Health Counselor
  • Lackawanna, NY
National Provider Identifier
1538859145
Registry record updated May 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
013293-01 Issued in NY
Practice address
790 Ridge Road
Lackawanna, NY 14218-3268
Phone
(716) 828-9699
Fax
(716) 828-9685
NPI assigned
May 9, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 9, 2023

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 013293-01 NY Primary

Addresses

Primary practice location

790 Ridge Road
Lackawanna, NY 14218-3268

Mailing address

790 Ridge Road
Lackawanna, NY 14218-3268
Phone (716) 828-9699

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
I20240919001146 NY Practitioner - Mental Health Counselor 8022559962 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
013293-01NYMDMental Health Counselor
013293NYMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Mid Erie Mental Health Services Inc CurrentSince Sep 1, 2024 Accepting new patients

Locations

1526 Walden Ave
Ste 400
Cheektowaga, NY 14225
Phone (716) 895-7167

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1683590400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683590400000",
    "number": "1538859145",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "790 RIDGE ROAD",
            "city": "LACKAWANNA",
            "state": "NY",
            "postal_code": "142183268",
            "telephone_number": "716-828-9699",
            "fax_number": "716-828-9685"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "790 RIDGE ROAD",
            "city": "LACKAWANNA",
            "state": "NY",
            "postal_code": "142183268",
            "telephone_number": "716-828-9699",
            "fax_number": "716-828-9685"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEGRON",
        "first_name": "NEMISIS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-05-09",
        "last_updated": "2023-05-09",
        "certification_date": "2023-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NY",
            "license": "013293-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lackawanna, NY

Sources for this page

Verify at the official NPI Registry.