Individual provider Active NPI

Alexis Kashmer

  • Mental Health Counselor
  • Fredonia, NY
National Provider Identifier
1679931737
Registry record updated Dec 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
009792 Issued in NY
Practice address
355 Central Avenue
Fredonia, NY 14063
Phone
(716) 672-6117
Fax
(716) 672-6120
NPI assigned
Feb 4, 2016
Last updated
Dec 6, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 6, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 009792 NY Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

355 Central Avenue
Fredonia, NY 14063

Mailing address

400 Forest Avenue
Buffalo, NY 14213
Phone (716) 885-2261

Other names 1

  • Alexis Perez Former name

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
I20240416000364 NY Order and Referring Only - Mental Health Counselor 9234578816

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
009792NYMDOccupational Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1454544000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701820800000",
    "number": "1679931737",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 FOREST AVENUE",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "14213",
            "telephone_number": "716-885-2261",
            "fax_number": "716-885-0710"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "355 CENTRAL AVENUE",
            "city": "FREDONIA",
            "state": "NY",
            "postal_code": "14063",
            "telephone_number": "716-672-6117",
            "fax_number": "716-672-6120"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KASHMER",
        "first_name": "ALEXIS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-02-04",
        "last_updated": "2023-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NY",
            "license": "009792",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ALEXIS",
            "last_name": "PEREZ",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Fredonia, NY

Sources for this page

Verify at the official NPI Registry.