Renee Katherine Larock-Gary, LMHC
Individual provider Active NPI Mental Health Counselor · Ticonderoga, NY
NPI 1700360732 · NPPES record last updated Aug 29, 2022
Key facts
- NPI
- 1700360732
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Mental Health Counselor 101YM0800X
- License
- 008982 (NY)
- Practice address
- 5 Morehous Dr
Ticonderoga, NY 12883-1110 - Phone
- (518) 586-4276
- Fax
- (844) 283-6959
- NPI assigned
- Sep 15, 2018
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 5
Medicare Care Compare profile
- Specialty
- Mental Health Counselor
- Education
- Other, 2012
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- MCCD Psychiatry Services PLLC
Practice addresses (Care Compare)
109 W 27TH St
5S
New York, NY 10001-6208
Phone (833) 351-8255
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (3 enrollments) in NY, NJ, MA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240115001473 | NY | Practitioner - Mental Health Counselor | 6507218682 | Reassigns benefits to 2 organizations |
| I20240418000166 | NJ | Practitioner - Mental Health Counselor | 6507218682 | Reassigns benefits to 2 organizations |
| I20260224003480 | MA | Practitioner - Mental Health Counselor | 6507218682 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 008982 | NY | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| MCCD Psychiatry Services PLLC | Current |
Accepting new patients | |
| Grow Healthcare Group of New Jersey PC | Mental Health | Current |
Accepting new patients |
| MCCD New Jersey Psychiatry Services LLC | Current |
Accepting new patients | |
| Grow Healthcare Group PA | Mental Health | Current |
Accepting new patients |
| Natural Dystopia | Past |
Accepting new patients |
Locations
100 Cambridge St
Fl 14
Boston, MA 02114
Phone (617) 917-2389
525 Route 73 N
Ste 117
Marlton, NJ 08053
Phone (609) 200-0444
165 Broadway
Fl 23
New York, NY 10006
Phone (202) 972-4964
109 W 27th St
Rm 5S
New York, NY 10001
Phone (332) 230-4572
109 W 27th St
New York, NY 10001
Phone (332) 206-6054
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 008982 | NY | |
| Mental Health Counselor | 101YM0800X | 008982 | NY | Yes |
Addresses
Primary practice location
5 Morehous Dr
Ticonderoga, NY 12883-1110
Mailing address
5 Morehous Dr
Ticonderoga, NY 12883-1110
Phone (518) 480-7208
Other names
- Renee Katherine Swinton
Other providers in Ticonderoga, NY
- James Edward Kelly Jr.
- Anne Kuhl
- Lacey J Lacourse
- Amy Lapierre
- Sarah Jane Lapointe
- Linda L Leavens
- Susan B Malaney
- Prashant Malhotra
- Richard N McKeever
- Robert Thomas McLaughlin
All providers in Ticonderoga, NY · Mental Health Counselor in New York
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 29, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.