Individual provider Active NPI

Mark William Lesniewski

  • Mental Health Counselor
  • Erie, PA
National Provider Identifier
1790212975
Registry record updated May 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
3800 W 12TH St Ste 7
Erie, PA 16505-3380
Phone
(814) 482-2209
NPI assigned
May 18, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 25, 2023

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 Primary

Addresses

Primary practice location

3800 W 12TH St Ste 7
Erie, PA 16505-3380

Mailing address

3800 W 12TH St Ste 7
Erie, PA 16505-3380
Phone (814) 482-2209

Other practice location 1

3350 Main St
Buffalo, NY 14214-1316
Phone (716) 819-3420

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective May 23, 2024 through May 23, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Forest Counseling, LLC CurrentSince Dec 1, 2020 Accepting new patients

Locations

3800 W 12th St
Ste 7
Erie, PA 16505
Phone (724) 813-9693

2700 W 21st St
Ste 5
Erie, PA 16506
Phone (814) 482-2209

Organizations & group practices 1

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": "1495065600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684972800000",
    "number": "1790212975",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3800 W 12TH ST STE 7",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165053380",
            "telephone_number": "814-482-2209",
            "fax_number": "814-200-1785"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3800 W 12TH ST STE 7",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165053380",
            "telephone_number": "814-482-2209"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3350 Main St",
            "address_purpose": "LOCATION",
            "city": "Buffalo",
            "state": "NY",
            "postal_code": "142141316",
            "country_code": "US",
            "telephone_number": "716-819-3420",
            "fax_number": "716-819-3430",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LESNIEWSKI",
        "first_name": "MARK",
        "middle_name": "WILLIAM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-05-18",
        "last_updated": "2023-05-25",
        "certification_date": "2023-05-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Erie, PA

Sources for this page

Verify at the official NPI Registry.