Individual provider Active NPI

Nicole S Laszlo

  • Mental Health Counselor
  • Watkins Glen, NY
National Provider Identifier
1902680705
Registry record updated Nov 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
017000 Issued in NY
Practice address
106 S Perry St Ste 4
Watkins Glen, NY 14891-1636
Phone
(607) 525-8282
NPI assigned
Aug 22, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 6, 2025

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 017000 NY Primary

Addresses

Primary practice location

106 S Perry St Ste 4
Watkins Glen, NY 14891-1636

Mailing address

106 S Perry St Ste 4
Watkins Glen, NY 14891-1636
Phone (607) 525-8282

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
I20251211003415 NY Practitioner - Mental Health Counselor 9537653050 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2023
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

106 S Perry St
Suite 4
Watkins Glen, NY 14891-1615

243 King Rd
Beaver Dams, NY 14812-9156

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
017000NYMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Schuyler County CurrentSince Nov 3, 2025 Accepting new patients
Schuyler County Mental Health CurrentSince Nov 3, 2025 Accepting new patients

Locations

106 S Perry St
Watkins Glen, NY 14891
Phone (607) 535-8140

106 S Perry St
Ste 4
Watkins Glen, NY 14891
Phone (607) 535-8282

Organizations & group practices 2

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": "1692662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762387200000",
    "number": "1902680705",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "106 S PERRY ST STE 4",
            "city": "WATKINS GLEN",
            "state": "NY",
            "postal_code": "148911636",
            "telephone_number": "607-525-8282"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "106 S PERRY ST STE 4",
            "city": "WATKINS GLEN",
            "state": "NY",
            "postal_code": "148911636",
            "telephone_number": "607-525-8282"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LASZLO",
        "first_name": "NICOLE",
        "middle_name": "S",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-08-22",
        "last_updated": "2025-11-06",
        "certification_date": "2025-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NY",
            "license": "017000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Watkins Glen, NY

Sources for this page

Verify at the official NPI Registry.