Individual provider Active NPI

Nancyann Laclair

  • Mental Health Counselor
  • North Syracuse, NY
National Provider Identifier
1790358356
Registry record updated Jul 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
011439 Issued in NY
Practice address
113 Church St
North Syracuse, NY 13212-2370
Phone
(315) 566-1348
NPI assigned
Jul 21, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 29, 2021

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 011439 NY Primary

Addresses

Primary practice location

113 Church St
North Syracuse, NY 13212-2370

Mailing address

629 Darlington Rd
Syracuse, NY 13208-2432
Phone (315) 566-1348

Other practice location 1

629 Darlington Rd
Syracuse, NY 13208-2432
Phone (315) 566-1348

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
I20250219000378 NY Practitioner - Mental Health Counselor 8224558465 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Branches of Growth Mental Health Counseling, PLLC Mental Health CurrentSince Nov 8, 2024 Accepting new patients
Branches of Growth, LLC Mental Health CurrentSince Aug 1, 2021 Accepting new patients

Locations

1 Adler Dr
Ste 5
East Syracuse, NY 13057
Phone (315) 415-0308

113 Church St
North Syracuse, NY 13212
Phone (315) 308-1062

Organizations & group practices 2

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": "1626825600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627516800000",
    "number": "1790358356",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "629 DARLINGTON RD",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132082432",
            "telephone_number": "315-566-1348"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "113 CHURCH ST",
            "city": "NORTH SYRACUSE",
            "state": "NY",
            "postal_code": "132122370",
            "telephone_number": "315-566-1348"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "629 Darlington Rd",
            "address_purpose": "LOCATION",
            "city": "Syracuse",
            "state": "NY",
            "postal_code": "132082432",
            "country_code": "US",
            "telephone_number": "315-566-1348",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LACLAIR",
        "first_name": "NANCYANN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-07-21",
        "last_updated": "2021-07-29",
        "certification_date": "2021-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NY",
            "license": "011439",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Syracuse, NY

Sources for this page

Verify at the official NPI Registry.