Mallorie Humphrey, LMHC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Practice address

113 Church St
North Syracuse, NY 13212-2370

Phone

(315) 415-0308

NPI assigned

Jan 20, 2021

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Branches of Growth, LLC

  • Mental Health Counselor
  • N Syracuse, NY
  • NPI 1902351216
  NPD
• Mindful Moments Mental Health Counseling, PLLC

  • Mental Health Counselor
  • Brooklyn, NY
  • NPI 1285216499
  NPD (past)

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

{
    "created_epoch": "1611100800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734134400000",
    "number": "1841880176",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "113 CHURCH ST",
            "city": "NORTH SYRACUSE",
            "state": "NY",
            "postal_code": "132122370",
            "telephone_number": "315-415-0308"
        },
        {
            "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": "315-415-0308"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUMPHREY",
        "first_name": "MALLORIE",
        "credential": "LMHC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-01-20",
        "last_updated": "2024-12-14",
        "certification_date": "2024-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gretchen Hoffman, R.PH.
• Matthew Andrew Holbok, FNP
• Mary Jane Houghton, OTR
• Roger Donnell Howard, M.S.
• Panna Shmouel Howil, DDS
• Enida Ibrahimovic
• Hannah Inglish, LMT
• Emily Ann Ippolito, LMSW
• Brian Michael Izzo, LPN
• Daina Wood Jakubowski, OTR

• Mental Health Counselor in North Syracuse, NY
• Providers in North Syracuse, NY by specialty
• Mental Health Counselor in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.