Individual provider Active NPI

Katie Roosa

  • Mental Health Counselor
  • Williamsville, NY
National Provider Identifier
1760338941
Registry record updated Mar 9, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
P125865 Issued in NY
Practice address
6265 Sheridan Dr Ste 122
Williamsville, NY 14221-4826
Phone
(716) 204-5552
Fax
(716) 204-5557
NPI assigned
Mar 9, 2026
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 9, 2026

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 P125865 NY Primary

Addresses

Primary practice location

6265 Sheridan Dr Ste 122
Williamsville, NY 14221-4826

Mailing address

4644 Peet St
Middleport, NY 14105-9698
Phone (716) 800-9755

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
P125865NYMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1773014400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773014400000",
    "number": "1760338941",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4644 PEET ST",
            "city": "MIDDLEPORT",
            "state": "NY",
            "postal_code": "141059698",
            "telephone_number": "716-800-9755",
            "fax_number": "716-204-5557"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6265 SHERIDAN DR STE 122",
            "city": "WILLIAMSVILLE",
            "state": "NY",
            "postal_code": "142214826",
            "telephone_number": "716-204-5552",
            "fax_number": "716-204-5557"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROOSA",
        "first_name": "KATIE",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-03-09",
        "last_updated": "2026-03-09",
        "certification_date": "2026-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NY",
            "license": "P125865",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Williamsville, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2026; 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.