Individual provider Active NPI

Erica Southwood

  • Counselor
  • Warsaw, NY
National Provider Identifier
1639738735
Registry record updated Jun 12, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
Practice address
34 N Main St
Warsaw, NY 14569-1326
Phone
(585) 786-0220
Fax
(585) 786-3631
NPI assigned
Jun 12, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 12, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X Primary

Addresses

Primary practice location

34 N Main St
Warsaw, NY 14569-1326

Mailing address

227 Thorn Ave
Orchard Park, NY 14127-2600
Phone (716) 662-2040

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
I20241022005053 NY Practitioner - Mental Health Counselor 0042743544 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Livingston CountyGroup PAC ID 8527027093, 10 clinicians

Practice addresses (Care Compare)

4600 Millennium Dr
Geneseo, NY 14454-1197
Phone (585) 243-7250

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Livingston County CurrentSince Aug 26, 2024 Accepting new patients
Livingston County CurrentSince Aug 26, 2024 Accepting new patients

Locations

4600 Millennium Dr
Geneseo, NY 14454
Phone (585) 243-7250

Organizations & group practices 2

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": "1560297600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560297600000",
    "number": "1639738735",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "227 THORN AVE",
            "city": "ORCHARD PARK",
            "state": "NY",
            "postal_code": "141272600",
            "telephone_number": "716-662-2040",
            "fax_number": "716-662-0019"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "34 N MAIN ST",
            "city": "WARSAW",
            "state": "NY",
            "postal_code": "145691326",
            "telephone_number": "585-786-0220",
            "fax_number": "585-786-3631"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOUTHWOOD",
        "first_name": "ERICA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-12",
        "last_updated": "2019-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Warsaw, NY

Sources for this page

Verify at the official NPI Registry.