Susan M Brockway, LMHC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

006718-1 Issued in NY

Practice address

4914 W Genesee St Ste 108
Camillus, NY 13031-2378

Phone

(315) 879-7743

Fax

(315) 928-1936

NPI assigned

Jun 30, 2017

Last updated

Feb 7, 2023By 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

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

Specialty

Mental Health Counselor

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1498780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675728000000",
    "number": "1720509698",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4112 BUTTONWOOD TRL",
            "city": "LIVERPOOL",
            "state": "NY",
            "postal_code": "130901103",
            "telephone_number": "315-879-7743"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4914 W GENESEE ST STE 108",
            "city": "CAMILLUS",
            "state": "NY",
            "postal_code": "130312378",
            "telephone_number": "315-879-7743",
            "fax_number": "315-928-1936"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4112 Buttonwood Trl",
            "address_purpose": "LOCATION",
            "city": "Liverpool",
            "state": "NY",
            "postal_code": "130901103",
            "country_code": "US",
            "telephone_number": "315-879-7743",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BROCKWAY",
        "first_name": "SUSAN",
        "middle_name": "M",
        "credential": "LMHC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-30",
        "last_updated": "2023-02-07",
        "certification_date": "2023-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NY",
            "license": "006718-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Madison Boyles
• Amy Braley
• Megan Brennan
• Gabriel Briggs, DPT
• Cynthia G Bright, MD
• Hanna Brovka
• Abigail Marie Brunner, NP
• David Bugin, H.I.S.
• McKenna Frances Burgwin, FNP-C
• Nicole Butler

• Mental Health Counselor in Camillus, NY
• Providers in Camillus, 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 Feb 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.