NPIMap

Individual provider Active NPI

Samantha Ciccarelli

  • Mental Health Counselor
  • Buffalo, NY
National Provider Identifier
1932405727
Registry record updated Oct 9, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
005542 Issued in NY
Practice address
1131 Broadway St
Buffalo, NY 14212-1501
Phone
(716) 896-7422
Fax
(716) 896-7717
NPI assigned
Jan 27, 2011
Last updated
Oct 9, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 9, 2014

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 005542 NY Primary

Addresses

Primary practice location

1131 Broadway St
Buffalo, NY 14212-1501

Mailing address

1526 Walden Ave Ste 400
Cheektowaga, NY 14225-4985

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

Practice roles

OrganizationSpecialtyStatusNew patients
Mid Erie Mental Health Services Inc PastSince Apr 1, 1996 Accepting new patients
Mid Erie 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": "1296086400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1412812800000",
    "number": "1932405727",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1526 WALDEN AVE STE 400",
            "city": "CHEEKTOWAGA",
            "state": "NY",
            "postal_code": "142254985"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1131 BROADWAY ST",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142121501",
            "telephone_number": "716-896-7422",
            "fax_number": "716-896-7717"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CICCARELLI",
        "first_name": "SAMANTHA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-01-27",
        "last_updated": "2014-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NY",
            "license": "005542",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Oct 9, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.