Alissa Blake Walruth, LMHC-D

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

013651 Issued in NY

Practice address

3 School Dr
Penn Yan, NY 14527-1081

Phone

(315) 924-6050

NPI assigned

Jul 18, 2023

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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

Specialty

Mental Health Counselor

Education

Other, 2020

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Finger Lakes Community Health

  • Federally Qualified Health Center (FQHC)
  • Port Byron, NY
  • NPI 1114198819
  Medicare reassignment
• Finger Lakes Community Health

  • Federally Qualified Health Center (FQHC)
  • Dundee, NY
  • NPI 1366939878
  NPD
• Finger Lakes Community Health

  • Federally Qualified Health Center (FQHC)
  • Bath, NY
  • NPI 1457689119
  NPD
• Finger Lakes Community Health

  • Federally Qualified Health Center (FQHC)
  • Sodus, NY
  • NPI 1669568465
  NPD (past)
• Finger Lakes Migrant Health Care Project, Inc.

  • Federally Qualified Health Center (FQHC)
  • Penn Yan, NY
  • NPI 1417643453
  NPD (past)

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

{
    "created_epoch": "1689638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1784073600000",
    "number": "1629758404",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601B W WASHINGTON ST",
            "city": "GENEVA",
            "state": "NY",
            "postal_code": "144562119",
            "telephone_number": "315-787-8151"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 SCHOOL DR",
            "city": "PENN YAN",
            "state": "NY",
            "postal_code": "145271081",
            "telephone_number": "315-924-6050"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "280 Princeton Avenue Ext",
            "address_purpose": "LOCATION",
            "city": "Corning",
            "state": "NY",
            "postal_code": "148301524",
            "country_code": "US",
            "telephone_number": "607-962-3146",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WALRUTH",
        "first_name": "ALISSA",
        "middle_name": "BLAKE",
        "credential": "LMHC-D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-07-18",
        "last_updated": "2026-07-15",
        "certification_date": "2026-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NY",
            "license": "013651",
            "primary": true
        },
        {
            "code": "101YS0200X",
            "taxonomy_group": "",
            "desc": "Counselor, School",
            "state": "NY",
            "license": "1578785221",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Douglas Calvin Wager, RPH
• Walgreen Co
• Lisa Lynn Walk-Reinard, M.D.
• Karen Long Walker
• Stacey Ann Walker, M.D.
• Water Street Pharmacy Inc.
• Water Street Pharmacy, Inc.
• Barbara J Weld, BACHELORS DEGREE
• Kathryn Ann Wiley, OT
• Susan B. Williams, MS

• Mental Health Counselor in Penn Yan, NY
• Providers in Penn Yan, 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 Jul 15, 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.