Jessica Carson, LMHC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

008244 Issued in NY

Practice address

1045 James St
Syracuse, NY 13203-2730

Phone

(315) 472-4471

Fax

(315) 472-1759

NPI assigned

Nov 5, 2015

Last updated

Mar 17, 2018By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Fortitude Mental Health Counseling, PLLC

  • Mental Health Counselor
  • East Syracuse, NY
  • NPI 1609568427
  NPD (past) Authorized official

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

{
    "created_epoch": "1446681600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1689047169",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17 EAST GENESEE STREET",
            "address_2": "CAYUGA COUNSELING SERVICES, INC.",
            "city": "AUBURN",
            "state": "NY",
            "postal_code": "13021",
            "telephone_number": "315-253-9795"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1045 JAMES ST",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132032730",
            "telephone_number": "315-472-4471",
            "fax_number": "315-472-1759"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "17 E Genesee St",
            "address_purpose": "LOCATION",
            "city": "Auburn",
            "state": "NY",
            "postal_code": "130214040",
            "country_code": "US",
            "telephone_number": "315-253-9795",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CARSON",
        "first_name": "JESSICA",
        "credential": "LMHC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-11-05",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NY",
            "license": "008244",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Annalise Marion Carroll
• Patricia Ann Carroll, OTR/L
• Precious Joy Carroll, REGISTERED NURSE
• Thomas Jeffrey Carroll, D.M.D.
• Michelle Anne Carruthers, OTR/L
• Kelli Carsten
• Todd Clement Carsten, DDS
• Latrenda H Carswell, PT ASST
• Amy Carter, MD
• Candace Sherida Carter, PMHNP

• Mental Health Counselor in Syracuse, NY
• Providers in Syracuse, NY by specialty
• Mental Health Counselor in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.