Active NPI
Jill Marie Dunstan, LMHC, CASAC
- Mental Health Counselor
- Hamburg, NY
National Provider Identifier
1770810608
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- LMHC-004391
- Practice address
- 190 Sunset Dr
Hamburg, NY 14075-4349 - Phone
- (716) 474-4400
- NPI assigned
- Nov 13, 2009
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 20452 | NY | |
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | CASAC-20452 | NY | |
| Mental Health Counselor | 101YM0800X | LMHC-004391 | NY | Primary |
Addresses
Primary practice location
190 Sunset Dr
Hamburg, NY 14075-4349
Mailing address
190 Sunset Dr
Hamburg, NY 14075-4349
Phone (716) 474-4400
Other practice location 1
254 Franklin Street
Buffalo, NY 14206
Phone (716) 852-1117
Other names 1
- Miss Jill Marie Izydorczak
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
| License | State | Type | Specialty |
|---|---|---|---|
| 20452 | NY | MD | Addiction (Substance Use Disorder) Counselor |
| CASAC-20452 | NY | MD | Addiction (Substance Use Disorder) Counselor |
| LMHC-004391 | NY | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1258070400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1647907200000",
"number": "1770810608",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "190 SUNSET DR",
"city": "HAMBURG",
"state": "NY",
"postal_code": "140754349",
"telephone_number": "716-474-4400"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "190 SUNSET DR",
"city": "HAMBURG",
"state": "NY",
"postal_code": "140754349",
"telephone_number": "716-474-4400"
}
],
"practiceLocations": [
{
"address_1": "254 Franklin Street",
"address_purpose": "LOCATION",
"city": "Buffalo",
"state": "NY",
"postal_code": "14206",
"country_code": "US",
"telephone_number": "716-852-1117",
"fax_number": "716-852-1110",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "DUNSTAN",
"first_name": "JILL",
"middle_name": "MARIE",
"name_prefix": "Mrs.",
"credential": "LMHC, CASAC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-11-13",
"last_updated": "2022-03-22",
"certification_date": "2022-03-22",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "NY",
"license": "20452",
"primary": false
},
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "NY",
"license": "CASAC-20452",
"primary": false
},
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "NY",
"license": "LMHC-004391",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "JILL",
"last_name": "IZYDORCZAK",
"middle_name": "MARIE",
"prefix": "MISS",
"credential": "LMHC, CASAC",
"code": "5",
"type": "Other Name"
}
]
}Other providers in Hamburg, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.