Nicholas Kime Ristoff, LMHC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

015454 Issued in NY

Practice address

635 James St Ste 2
Syracuse, NY 13203-2681

Phone

(315) 382-3766

NPI assigned

Dec 10, 2024

Last updated

Dec 10, 2024By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Liberty Resources Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Syracuse, NY
  • NPI 1225254881
  Medicare reassignment NPD
• Liberty Resources, Inc.

  • Federally Qualified Health Center (FQHC)
  • Fulton, NY
  • NPI 1700688827
  NPD
• Liberty Resources, Inc.

  • Primary Care Clinic/Center
  • Syracuse, NY
  • NPI 1821485483
  NPD

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

{
    "created_epoch": "1733788800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733788800000",
    "number": "1770399164",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "204 WILLIS AVE",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132041944"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "635 JAMES ST STE 2",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132032681",
            "telephone_number": "315-382-3766"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RISTOFF",
        "first_name": "NICHOLAS",
        "middle_name": "KIME",
        "credential": "LMHC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-12-10",
        "last_updated": "2024-12-10",
        "certification_date": "2024-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NY",
            "license": "015454",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jeanmarie Ripke, SLP
• Mary Elizabeth Riposo, PHD, LMHC
• Rebecca Risewick, PA-C
• Vivek Rishi, MBBS
• Karen V. Ristoff, MS, LMHC
• Rite Aid of New York Inc (Rite Aid Pharmacy 00632)
• Rite Aid of New York Inc (Rite Aid Pharmacy 00631)
• Rite Aid of New York Inc (Rite Aid Pharmacy 03623)
• Rite Aid of New York Inc (Rite Aid Pharmacy 04297)
• Rite Aid of New York Inc (Rite Aid Pharmacy 00633)

• Mental Health Counselor in Syracuse, NY
• Providers in Syracuse, 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 Dec 10, 2024; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.