Individual provider Active NPI

Marian Ruth Bauman-O'Dell, LMHC, CASAC

  • Mental Health Counselor
  • Rochester, NY
National Provider Identifier
1609015635
Registry record updated Feb 15, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
000846 Issued in NY
Practice address
1355 Titus Ave
Rochester, NY 14622-1731
Phone
(585) 748-1209
NPI assigned
Feb 15, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 15, 2009

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 4223 NY
Mental Health Counselor 101YM0800X 000846 NY Primary

Addresses

Primary practice location

1355 Titus Ave
Rochester, NY 14622-1731

Mailing address

560 Barry Rd
Rochester, NY 14617-4742
Phone (585) 748-1209

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
4223NYMDAddiction (Substance Use Disorder) Counselor
000846NYMDAdvanced Practice Midwife

NPI Registry JSON

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

{
    "created_epoch": "1234656000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1234656000000",
    "number": "1609015635",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "560 BARRY RD",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146174742",
            "telephone_number": "585-748-1209"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1355 TITUS AVE",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146221731",
            "telephone_number": "585-748-1209"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAUMAN-O'DELL",
        "first_name": "MARIAN",
        "middle_name": "RUTH",
        "name_prefix": "Mrs.",
        "credential": "LMHC, CASAC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-02-15",
        "last_updated": "2009-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NY",
            "license": "4223",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NY",
            "license": "000846",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rochester, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2009; 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.