Individual provider Active NPI

Amanda Ashley Vacca, LMHC

  • Mental Health Counselor
  • Harrison, NY
National Provider Identifier
1760912216
Registry record updated Apr 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
009589 Issued in NY
Practice address
275 North St
Harrison, NY 10528-1140
Phone
(914) 925-5416
NPI assigned
Jun 18, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 8, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X
Mental Health Counselor 101YM0800X 009589 NY Primary

Addresses

Primary practice location

275 North St
Harrison, NY 10528-1140

Mailing address

4 Bragdon Ave
Danbury, CT 06811-3410

Other names 1

  • Amanda Ashley Gomes Former name

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
I20250605002795 NY Practitioner - Mental Health Counselor 5294245692 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
009589NYMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
St.Vincent' Hospital Westchester Psych CurrentSince Mar 16, 2025 Accepting new patients
St Josephs Hospital Yonkers CurrentSince Mar 16, 2025 Accepting new patients
Mindful Living Counseling & Consulting LLC Mental Health Current Accepting new patients
St. Joseph'S Hospital Yonkers Current Accepting new patients

Locations

275 North St
Harrison, NY 10528
Phone (914) 925-5211

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1497744000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744070400000",
    "number": "1760912216",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 BRAGDON AVE",
            "city": "DANBURY",
            "state": "CT",
            "postal_code": "068113410"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "275 NORTH ST",
            "city": "HARRISON",
            "state": "NY",
            "postal_code": "105281140",
            "telephone_number": "914-925-5416"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VACCA",
        "first_name": "AMANDA",
        "middle_name": "ASHLEY",
        "credential": "LMHC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-06-18",
        "last_updated": "2025-04-08",
        "certification_date": "2025-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NY",
            "license": "009589",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMANDA",
            "last_name": "GOMES",
            "middle_name": "ASHLEY",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Harrison, NY

Sources for this page

Verify at the official NPI Registry.