Individual provider Active NPI

Annamarie L Incorvaia, LMHC

  • Mental Health Counselor
  • Buffalo, NY
National Provider Identifier
1821516717
Registry record updated Aug 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
100515 Issued in NY
Practice address
1170 Main St FL 4
Buffalo, NY 14209-2380
Phone
(716) 883-1914
NPI assigned
Aug 31, 2017
Last updated
Aug 21, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 21, 2024

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 100515 NY Primary

Addresses

Primary practice location

1170 Main St FL 4
Buffalo, NY 14209-2380

Mailing address

1170 Main St FL 4
Buffalo, NY 14209-2380
Phone (716) 883-1914

Other practice location 1

4220 State Route 417 W
Wellsville, NY 14895-9332
Phone (585) 593-6300 ext. 240

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
I20250424001323 NY Practitioner - Mental Health Counselor 2668998444 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Jewish Family Services of Western New YorkGroup PAC ID 3173509593, 4 clinicians

Practice addresses (Care Compare)

1170 Main St
FL 4
Buffalo, NY 14209-2380
Phone (716) 883-1914

70 Barker St
Buffalo, NY 14209-2013

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
100515NYMDMental Health Counselor

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1504137600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724198400000",
    "number": "1821516717",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1170 MAIN ST FL 4",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142092380",
            "telephone_number": "716-883-1914"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1170 MAIN ST FL 4",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142092380",
            "telephone_number": "716-883-1914"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4220 State Route 417 W",
            "address_purpose": "LOCATION",
            "city": "Wellsville",
            "state": "NY",
            "postal_code": "148959332",
            "country_code": "US",
            "telephone_number": "585-593-6300 x240",
            "fax_number": "585-593-7071",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "INCORVAIA",
        "first_name": "ANNAMARIE",
        "middle_name": "L",
        "credential": "LMHC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-08-31",
        "last_updated": "2024-08-21",
        "certification_date": "2024-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NY",
            "license": "100515",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Buffalo, NY

Sources for this page

Verify at the official NPI Registry.