Individual provider Active NPI

Claire J. Bobrycki, LCSW

  • Mental Health Counselor
  • Auburn, NY
National Provider Identifier
1902915465
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
R046248-1 Issued in NY
Practice address
2 South St Ste 204
Auburn, NY 13021-3833
Phone
(315) 252-6978
Fax
(315) 252-6978
NPI assigned
Aug 29, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 R046248-1 NY Primary

Addresses

Primary practice location

2 South St Ste 204
Auburn, NY 13021-3833

Mailing address

120 Alden St
Syracuse, NY 13210-3604
Phone (315) 426-1294

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
I20130508000314 NY Practitioner - Clinical Social Worker 3173760329 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
R046248-1NYMDMental Health Counselor
046248NYMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Jonathan Loomis Past Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1156809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1902915465",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 ALDEN ST",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132103604",
            "telephone_number": "315-426-1294"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 SOUTH ST STE 204",
            "city": "AUBURN",
            "state": "NY",
            "postal_code": "130213833",
            "telephone_number": "315-252-6978",
            "fax_number": "315-252-6978"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOBRYCKI",
        "first_name": "CLAIRE",
        "middle_name": "J.",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-29",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NY",
            "license": "R046248-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Auburn, NY

Sources for this page

Verify at the official NPI Registry.