Mikaela Tubolino, LMHC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

012934 Issued in NY

Practice address

114 Oneida St
Fulton, NY 13069-1213

Phone

(315) 333-2234

NPI assigned

May 7, 2015

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Locations

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.

• Upstate Virtual Counseling

  • Mental Health Counselor
  • Fulton, NY
  • NPI 1346008679
  NPD Authorized official

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

{
    "created_epoch": "1430956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710288000000",
    "number": "1962880187",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5299",
            "city": "OSWEGO",
            "state": "NY",
            "postal_code": "131265299",
            "telephone_number": "315-289-6679"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "114 ONEIDA ST",
            "city": "FULTON",
            "state": "NY",
            "postal_code": "130691213",
            "telephone_number": "315-333-2234"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TUBOLINO",
        "first_name": "MIKAELA",
        "name_prefix": "Dr.",
        "credential": "LMHC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-05-07",
        "last_updated": "2024-03-13",
        "certification_date": "2024-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NY",
            "license": "012934",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lisa Marie Thrash, LPN
• Dilvir S Toor, DDS
• Mark Louis Toscano, RPH.
• Kimberley Trail
• Stuart Trust, DO
• Garrett Andrew Turtura, LIMITED PERMIT MHC
• Dorothy Tyler, R.PH.
• Sandra L Upcraft, OPHTHALMIC DISPENSER
• Upstate Pain Medicine PC
• Upstate Virtual Counseling

• Mental Health Counselor in Fulton, NY
• Providers in Fulton, NY by specialty
• Mental Health Counselor in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2024; 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.