Individual provider Active NPI

Kathleen Crissey

  • Mental Health Counselor
  • Williamsville, NY
National Provider Identifier
1689829780
Registry record updated Mar 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
001479 Issued in NY
Practice address
2805 Wehrle Dr Ste 1
Williamsville, NY 14221-7383
Phone
(716) 807-9494
NPI assigned
Nov 18, 2008
Last updated
Mar 25, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 25, 2024

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 001479 NY Primary

Addresses

Primary practice location

2805 Wehrle Dr Ste 1
Williamsville, NY 14221-7383

Mailing address

153 W Utica St
Buffalo, NY 14222-2017
Phone (716) 884-7569

Other practice location 1

153 W Utica St
Buffalo, NY 14222-2017
Phone (716) 884-7569

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
I20240327000267 NY Practitioner - Mental Health Counselor 4284007824 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Church Mission of Help of Western New York Inc.Group PAC ID 9931013059, 9 clinicians

Practice addresses (Care Compare)

153 W Utica St
Buffalo, NY 14222-2017
Phone (716) 884-7569

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
001479NYMDAcupuncturist

Practice roles

OrganizationSpecialtyStatusNew patients
Child and Adolescent Treatment Service Inc Mental Health 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1226966400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711324800000",
    "number": "1689829780",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "153 W UTICA ST",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142222017",
            "telephone_number": "716-884-7569"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2805 WEHRLE DR STE 1",
            "city": "WILLIAMSVILLE",
            "state": "NY",
            "postal_code": "142217383",
            "telephone_number": "716-807-9494"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "153 W Utica St",
            "address_purpose": "LOCATION",
            "city": "Buffalo",
            "state": "NY",
            "postal_code": "142222017",
            "country_code": "US",
            "telephone_number": "716-884-7569",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CRISSEY",
        "first_name": "KATHLEEN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-11-18",
        "last_updated": "2024-03-25",
        "certification_date": "2024-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NY",
            "license": "001479",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Williamsville, NY

Sources for this page

Verify at the official NPI Registry.