Megan Brautlacht, LMHC-P

Key facts

NPI

1891206231

Entity type

Individual (NPI type 1)

Primary specialty

Mental Health Counselor 101YM0800X

Practice address

6722 Erie Rd
Derby, NY 14047-9670

Phone

(716) 947-5025

NPI assigned

Oct 12, 2017

Sex

Female

Sole proprietor

No

Medicare participation

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)

Yes

State licenses

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Oct 12, 2017.

{
    "created_epoch": "1507766400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1507766400000",
    "number": "1891206231",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5714 APOLLO DR",
            "city": "LAKE VIEW",
            "state": "NY",
            "postal_code": "140859637",
            "telephone_number": "716-474-3502"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6722 ERIE RD",
            "city": "DERBY",
            "state": "NY",
            "postal_code": "140479670",
            "telephone_number": "716-947-5025"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRAUTLACHT",
        "first_name": "MEGAN",
        "name_prefix": "Ms.",
        "credential": "LMHC-P",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-10-12",
        "last_updated": "2017-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NY",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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All providers in Derby, NY · Mental Health Counselor in New York