Individual provider Active NPI

Amy Lee Hackett

  • Mental Health Counselor
  • Hamburg, NY
National Provider Identifier
1841573136
Registry record updated Nov 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
7062 Issued in NY
Practice address
140 Pine St
Hamburg, NY 14075
Phone
(716) 646-4991
Fax
(716) 646-4990
NPI assigned
Sep 22, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 20, 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 7062 NY Primary

Addresses

Primary practice location

140 Pine St
Hamburg, NY 14075

Mailing address

16 Northridge Dr
Arcade, NY 14009-1028
Phone (585) 969-2910

Other practice location 1

4211 N Buffalo Rd Ste 4
Orchard Park, NY 14127-2401
Phone (716) 539-0041

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

State licenses

LicenseStateTypeSpecialty
7062NYMDMental Health Counselor
007062NYMDAcupuncturist

Practice roles

OrganizationSpecialtyStatusNew patients
Your Story Mental Health Counseling, PLLC CurrentSince Oct 29, 2023 Accepting new patients

Locations

4211 N Buffalo Rd
Ste 4
Orchard Park, NY 14127
Phone (716) 539-0041

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": "1316649600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700438400000",
    "number": "1841573136",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16 NORTHRIDGE DR",
            "city": "ARCADE",
            "state": "NY",
            "postal_code": "140091028",
            "telephone_number": "585-969-2910"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "140 PINE ST",
            "city": "HAMBURG",
            "state": "NY",
            "postal_code": "14075",
            "telephone_number": "716-646-4991",
            "fax_number": "716-646-4990"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4211 N Buffalo Rd Ste 4",
            "address_purpose": "LOCATION",
            "city": "Orchard Park",
            "state": "NY",
            "postal_code": "141272401",
            "country_code": "US",
            "telephone_number": "716-539-0041",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HACKETT",
        "first_name": "AMY",
        "middle_name": "LEE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-09-22",
        "last_updated": "2023-11-20",
        "certification_date": "2023-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NY",
            "license": "7062",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Nov 20, 2023; 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.