Individual provider Active NPI

Beth Northup, LMHC

  • Mental Health Counselor
  • Rensselaer, NY
National Provider Identifier
1699361576
Registry record updated Dec 15, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
003887-1 Issued in NY
Practice address
516 Washington Ave
Rensselaer, NY 12144-1440
Phone
(845) 800-1062
NPI assigned
Dec 15, 2020
Last updated
Dec 15, 2020By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 15, 2020

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 003887-1 NY Primary

Addresses

Primary practice location

516 Washington Ave
Rensselaer, NY 12144-1440

Mailing address

815 Washington Ave
Rensselaer, NY 12144-1327
Phone (845) 800-1062

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
I20251113001876 NY Practitioner - Mental Health Counselor 5597255331 Practice locations: Rensselaer, NY

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 1997
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

516 Washington Ave
Rensselaer, NY 12144-1440
Phone (845) 800-1062

815 Washington Ave
Rensselaer, NY 12144-1327

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
003887-1NYMDRegistered Dietitian

NPI Registry JSON

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

{
    "created_epoch": "1607990400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607990400000",
    "number": "1699361576",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "815 WASHINGTON AVE",
            "city": "RENSSELAER",
            "state": "NY",
            "postal_code": "121441327",
            "telephone_number": "845-800-1062"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "516 WASHINGTON AVE",
            "city": "RENSSELAER",
            "state": "NY",
            "postal_code": "121441440",
            "telephone_number": "845-800-1062"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NORTHUP",
        "first_name": "BETH",
        "credential": "LMHC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-12-15",
        "last_updated": "2020-12-15",
        "certification_date": "2020-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NY",
            "license": "003887-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rensselaer, NY

Sources for this page

Verify at the official NPI Registry.