Individual provider Active NPI

Alexandra Mott

  • Professional Counselor
  • Derby, NY
National Provider Identifier
1750770673
Registry record updated Mar 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
008107 Issued in NY
Practice address
6910 Hamilton Dr
Derby, NY 14047-9517
Phone
(716) 352-9722
NPI assigned
Jan 15, 2015
Last updated
Mar 19, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 19, 2024

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

Specialties & licenses 8

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X NU
Professional Counselor 101YP2500X 11224 CA
Professional Counselor 101YP2500X LPC0018775 CO
Professional Counselor 101YP2500X 21591 AZ
Professional Counselor 101YP2500X 13069748-6004 UT
Professional Counselor 101YP2500X 37PC00971800 NJ
Professional Counselor 101YP2500X 92599 TX
Professional Counselor 101YP2500X 008107 NY Primary

Addresses

Primary practice location

6910 Hamilton Dr
Derby, NY 14047-9517

Mailing address

6910 Hamilton Dr
Derby, NY 14047-9517
Phone (716) 352-9722

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
21591AZMDProfessional Counselor
11224CAMDProfessional Counselor
LPC0018775COMDProfessional Counselor
37PC00971800NJMDProfessional Counselor
008107NYMDProfessional Counselor
92599TXMDProfessional Counselor
13069748-6004UTMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Mid Erie Past Accepting new patients
Uplift Behavioral Health PC Past Accepting new patients
Shine Medical of Ca PC Past Accepting new patients

Organizations & group practices 3

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": "1421280000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710806400000",
    "number": "1750770673",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6910 HAMILTON DR",
            "city": "DERBY",
            "state": "NY",
            "postal_code": "140479517",
            "telephone_number": "716-352-9722"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6910 HAMILTON DR",
            "city": "DERBY",
            "state": "NY",
            "postal_code": "140479517",
            "telephone_number": "716-352-9722"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOTT",
        "first_name": "ALEXANDRA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-01-15",
        "last_updated": "2024-03-19",
        "certification_date": "2024-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "CA",
            "license": "11224",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "CO",
            "license": "LPC0018775",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "AZ",
            "license": "21591",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "UT",
            "license": "13069748-6004",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NJ",
            "license": "37PC00971800",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "92599",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NY",
            "license": "008107",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Derby, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2024; 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.