MEDICARE: KAREN V. RISTOFF MS, LMHC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	011087	NY

General Provider Information

NPI Number	:	1467094888
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KAREN V. RISTOFF MS, LMHC

Provider Business Mailing Address
First Line	:	525 W MANCHESTER RD
Second Line	:
City	:	SYRACUSE
State	:	NY
Zip	:	13219-2419
Country	:	US
Telephone Number	:	315-345-0021
Fax Number	:

Provider Business Practice Location Address
First Line	:	525 W MANCHESTER RD
Second Line	:
City	:	SYRACUSE
State	:	NY
Zip	:	13219-2419
Country	:	US
Telephone Number	:	315-345-0021
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/17/2019
Last Update Date	:	04/06/2025

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