=====================================================
General NPI Number Information
=====================================================
NPI Number | 1558133314
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | AMY SCHIMINSKE LMHC
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/25/2023
-----------------------------------------------------
Last Update Date | 10/22/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 890 7TH NORTH ST STE 100&200
-----------------------------------------------------
City | LIVERPOOL
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 13088-6558
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 315-422-0300
-----------------------------------------------------
Fax | 833-449-5098
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 890 7TH NORTH ST STE 100&200
-----------------------------------------------------
City | LIVERPOOL
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 13088-6558
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 315-422-0300
-----------------------------------------------------
Fax | 833-449-5098
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101YM0800X
-----------------------------------------------------
Taxonomy Name | Mental Health Counselor
-----------------------------------------------------
License Number | 014010-01
-----------------------------------------------------
License Number State | NY
-----------------------------------------------------