Individual provider Active NPI

Gail E Holler-Kennedy, LMHC

  • Mental Health Counselor
  • North Tonawanda, NY
National Provider Identifier
1790839447
Registry record updated Nov 22, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
000501 Issued in NY
Practice address
7348 Bear Ridge Rd
North Tonawanda, NY 14120-9520
Phone
(716) 200-9448
NPI assigned
Jan 22, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 22, 2013

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 000501 NY Primary

Addresses

Primary practice location

7348 Bear Ridge Rd
North Tonawanda, NY 14120-9520

Mailing address

1868 Niagara Falls Blvd
Suite 306
Tonawanda, NY 14150-6494
Phone (716) 200-9448

Other identifiers 3

IdentifierTypeStateIssuer
000506354005OtherNYCOMMUNITY BLUE
00030241501OtherNYUNIVERA
091202000104OtherNYFIDELIS

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)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1169424000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1385078400000",
    "number": "1790839447",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1868 NIAGARA FALLS BLVD",
            "address_2": "SUITE 306",
            "city": "TONAWANDA",
            "state": "NY",
            "postal_code": "141506494",
            "telephone_number": "716-200-9448"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7348 BEAR RIDGE RD",
            "city": "NORTH TONAWANDA",
            "state": "NY",
            "postal_code": "141209520",
            "telephone_number": "716-200-9448"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLLER-KENNEDY",
        "first_name": "GAIL",
        "middle_name": "E",
        "credential": "LMHC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-22",
        "last_updated": "2013-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NY",
            "license": "000501",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COMMUNITY BLUE",
            "identifier": "000506354005",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNIVERA",
            "identifier": "00030241501",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIDELIS",
            "identifier": "091202000104",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in North Tonawanda, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.