Individual provider Active NPI

Kara Lynn Elliott

  • Mental Health Counselor
  • Orchard Park, NY
National Provider Identifier
1679700892
Registry record updated Feb 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
012564-01 Issued in NY
Practice address
3345 Southwestern Blvd Ste 100
Orchard Park, NY 14127-1506
Phone
(716) 662-6802
NPI assigned
Jun 15, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 6, 2023

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 012564-01 NY Primary

Addresses

Primary practice location

3345 Southwestern Blvd Ste 100
Orchard Park, NY 14127-1506

Mailing address

55 Dodge Rd
Getzville, NY 14068-1205
Phone (716) 831-2700

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Feb 28, 2025 through Feb 28, 2027

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
012564-01NYMDMental Health Counselor
012564NYMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1245024000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675641600000",
    "number": "1679700892",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 DODGE RD",
            "city": "GETZVILLE",
            "state": "NY",
            "postal_code": "140681205",
            "telephone_number": "716-831-2700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3345 SOUTHWESTERN BLVD STE 100",
            "city": "ORCHARD PARK",
            "state": "NY",
            "postal_code": "141271506",
            "telephone_number": "716-662-6802"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLIOTT",
        "first_name": "KARA",
        "middle_name": "LYNN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-06-15",
        "last_updated": "2023-02-06",
        "certification_date": "2023-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NY",
            "license": "012564-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orchard Park, NY

Sources for this page

Verify at the official NPI Registry.