Active NPI
Patrick Mackenna, CASAC-T
- Addiction (Substance Use Disorder) Counselor
- Buffalo, NY
National Provider Identifier
1891868162
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- License
- 20011
- Practice address
- 425 Michigan Ave
Buffalo, NY 14203-2209 - Phone
- (716) 848-2000
- Fax
- (716) 848-2112
- NPI assigned
- Nov 16, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 20011 | NY | Primary |
Addresses
Primary practice location
425 Michigan Ave
Buffalo, NY 14203-2209
Mailing address
425 Michigan Ave
Buffalo, NY 14203-2209
Phone (716) 848-2000
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 20011 | Other | NY | CASAC-T |
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 20011 | NY | MD | Addiction (Substance Use Disorder) Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1163635200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1295827200000",
"number": "1891868162",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "425 MICHIGAN AVE",
"city": "BUFFALO",
"state": "NY",
"postal_code": "142032209",
"telephone_number": "716-848-2000",
"fax_number": "716-848-2112"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "425 MICHIGAN AVE",
"city": "BUFFALO",
"state": "NY",
"postal_code": "142032209",
"telephone_number": "716-848-2000",
"fax_number": "716-848-2112"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MACKENNA",
"first_name": "PATRICK",
"credential": "CASAC-T",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-11-16",
"last_updated": "2011-01-24",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "NY",
"license": "20011",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CASAC-T",
"identifier": "20011",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Buffalo, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.