Individual provider Active NPI

Michelle Vazquez, LMHC

  • Mental Health Counselor
  • Fuquay Varina, NC
National Provider Identifier
1992124168
Registry record updated Feb 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
009927-01 Issued in NY
Practice address
926 Ribbonleaf LN
Fuquay Varina, NC 27526-3716
Phone
(551) 265-0982
NPI assigned
Apr 15, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 7, 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 009927-01 NY Primary

Addresses

Primary practice location

926 Ribbonleaf LN
Fuquay Varina, NC 27526-3716

Mailing address

318 Lillian Ave
Syracuse, NY 13206-2156
Phone (516) 500-7660

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
I20250227001350 NY Practitioner - Mental Health Counselor 2769902238 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2013
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services
Group practices
Osier Health PCGroup PAC ID 6507229317, 12 clinicians

Practice addresses (Care Compare)

169 Madison Ave
New York, NY 10016-5101
Phone (646) 814-1530

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
009927-01NYMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Osier Health PC Mental Health CurrentSince Dec 23, 2024 Accepting new patients
Willow Health, Inc Past Accepting new patients

Locations

169 Madison Ave
#15906
New York, NY 10016
Phone (646) 814-1530

169 Madison Ave
Ste 15906
New York, NY 10016

Interoperability endpoints

  • Direct secure messaging: michelle.vazquez@549960591081476.direct.elationemr.com

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": "1397520000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738886400000",
    "number": "1992124168",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "318 LILLIAN AVE",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132062156",
            "telephone_number": "516-500-7660"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "926 RIBBONLEAF LN",
            "city": "FUQUAY VARINA",
            "state": "NC",
            "postal_code": "275263716",
            "telephone_number": "551-265-0982"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAZQUEZ",
        "first_name": "MICHELLE",
        "name_prefix": "Ms.",
        "credential": "LMHC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-04-15",
        "last_updated": "2025-02-07",
        "certification_date": "2025-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NY",
            "license": "009927-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fuquay Varina, NC

Sources for this page

Verify at the official NPI Registry.