Active NPI
Denise McIntosh, CASAC
- Addiction (Substance Use Disorder) Counselor
- Rochester, NY
National Provider Identifier
1649544271
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- License
- 17103
- Practice address
- 1150 University Ave
Suite 7
Rochester, NY 14607-1647 - Phone
- (585) 442-8422
- Fax
- (585) 442-8494
- NPI assigned
- Feb 29, 2012
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 17103 | NY | Primary |
Addresses
Primary practice location
1150 University Ave
Suite 7
Rochester, NY 14607-1647
Mailing address
PO Box 417153
Boston, MA 02241-7153
Phone (518) 952-8140
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 03008239 | Medicaid | NY |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 17103 | NY | MD | Addiction (Substance Use Disorder) Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Conifer Park, Inc. | Past | Accepting new patients | |
| Conifer Park, Inc. | Past | Accepting new patients |
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.
-
- Substance Use Disorder Rehabilitation Clinic/Center
- Rochester, NY
- NPI 1235185612
-
- Substance Use Disorder Rehabilitation Clinic/Center
- Liverpool, NY
- NPI 1366498768
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1330473600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1330473600000",
"number": "1649544271",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 417153",
"city": "BOSTON",
"state": "MA",
"postal_code": "022417153",
"telephone_number": "518-952-8140",
"fax_number": "518-952-8287"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1150 UNIVERSITY AVE",
"address_2": "SUITE 7",
"city": "ROCHESTER",
"state": "NY",
"postal_code": "146071647",
"telephone_number": "585-442-8422",
"fax_number": "585-442-8494"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCINTOSH",
"first_name": "DENISE",
"credential": "CASAC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-02-29",
"last_updated": "2012-02-29",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "NY",
"license": "17103",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "03008239",
"state": "NY"
}
],
"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 29, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.