Active NPI
Lourdes Faride Brache-Tabar, LMHC
- Mental Health Counselor
- Syracuse, NY
National Provider Identifier
1992476188
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 001711-01
- Practice address
- 600 E Genesee St
Syracuse, NY 13202-3130 - Phone
- (315) 516-8466
- NPI assigned
- Sep 27, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 001711-01 | NY | Primary |
Addresses
Primary practice location
600 E Genesee St
Syracuse, NY 13202-3130
Mailing address
1002 Euclid Avemue
Syracuse, NY 13210
Phone (607) 342-2088
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
| License | State | Type | Specialty |
|---|---|---|---|
| 001711-01 | NY | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1632700800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1632700800000",
"number": "1992476188",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1002 EUCLID AVEMUE",
"city": "SYRACUSE",
"state": "NY",
"postal_code": "13210",
"telephone_number": "607-342-2088"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "600 E GENESEE ST",
"city": "SYRACUSE",
"state": "NY",
"postal_code": "132023130",
"telephone_number": "315-516-8466"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRACHE-TABAR",
"first_name": "LOURDES",
"middle_name": "FARIDE",
"credential": "LMHC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-09-27",
"last_updated": "2021-09-27",
"certification_date": "2021-09-09",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "NY",
"license": "001711-01",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Syracuse, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.