Individual provider Active NPI

Tyranny Alaska Chartrand, LMSW

  • Mental Health Counselor
  • Utica, NY
National Provider Identifier
1972311488
Registry record updated Dec 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
126260 Issued in NY
Practice address
628 Mary St
Utica, NY 13501-2419
Phone
(315) 272-2600
NPI assigned
Dec 30, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 30, 2024

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 126260 NY Primary

Addresses

Primary practice location

628 Mary St
Utica, NY 13501-2419

Mailing address

5491 State Route 410
Castorland, NY 13620-2311
Phone (315) 955-5244

Other practice location 1

199 W Dominick St # 195
Rome, NY 13440-5858
Phone (315) 272-2600

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

LicenseStateTypeSpecialty
126260NYMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1735516800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735516800000",
    "number": "1972311488",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5491 STATE ROUTE 410",
            "city": "CASTORLAND",
            "state": "NY",
            "postal_code": "136202311",
            "telephone_number": "315-955-5244"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "628 MARY ST",
            "city": "UTICA",
            "state": "NY",
            "postal_code": "135012419",
            "telephone_number": "315-272-2600"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "199 W Dominick St # 195",
            "address_purpose": "LOCATION",
            "city": "Rome",
            "state": "NY",
            "postal_code": "134405858",
            "country_code": "US",
            "telephone_number": "315-272-2600",
            "fax_number": "315-733-8169",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHARTRAND",
        "first_name": "TYRANNY",
        "middle_name": "ALASKA",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-12-30",
        "last_updated": "2024-12-30",
        "certification_date": "2024-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NY",
            "license": "126260",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Utica, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 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.