Individual provider Active NPI

Jill Marie Connors Letizia, LMHC

  • Mental Health Counselor
  • Syracuse, NY
National Provider Identifier
1669922233
Registry record updated Oct 7, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
006639 Issued in NY
Practice address
321 W Onondaga St
Syracuse, NY 13202-3207
Phone
(315) 478-0610
Fax
(315) 478-2510
NPI assigned
Oct 7, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 7, 2016

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 006639 NY Primary

Addresses

Primary practice location

321 W Onondaga St
Syracuse, NY 13202-3207

Mailing address

321 W Onondaga St
Syracuse, NY 13202-3207
Phone (315) 478-0610

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
I20241120002052 NY Practitioner - Mental Health Counselor 1052846524

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2008
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

129 N Way
Camillus, NY 13031-1253

27 Randolph Rd
Howell, NJ 07731-8611

66 E Flagler St
Miami, FL 33130-1807

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
006639NYMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Central New York Services, Inc. Past Accepting new patients
Central New York Services, 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.

NPI Registry JSON

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

{
    "created_epoch": "1475798400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1475798400000",
    "number": "1669922233",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "321 W ONONDAGA ST",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132023207",
            "telephone_number": "315-478-0610",
            "fax_number": "315-478-2510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "321 W ONONDAGA ST",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132023207",
            "telephone_number": "315-478-0610",
            "fax_number": "315-478-2510"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LETIZIA",
        "first_name": "JILL",
        "middle_name": "MARIE CONNORS",
        "credential": "LMHC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-10-07",
        "last_updated": "2016-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NY",
            "license": "006639",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Syracuse, NY

Sources for this page

Verify at the official NPI Registry.