ANTOINETTE TRISTAN LMHC
NPI 1205204401
Counselor in Ithaca, NY

Q: What is Antoinette Tristan's NPI number?

The NPI number for Antoinette Tristan is 1205204401. It was assigned to this individual provider in the NPPES registry on September 4, 2015.

Q: What is Antoinette Tristan's specialty?

The primary specialty registered for this NPI is Counselor with taxonomy code 101Y00000X.

Active since September 04, 2015PECOS Enrolled

127 W STATE ST, ITHACA, NY 14850(607) 273-7494 Get Directions Write a Review

NPPES record last updated: December 20, 2022. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Dec 20, 2022, Aug 24, 2017 (2 updates tracked since 2017).

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About Antoinette Tristan Lmhc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

ANTOINETTE TRISTAN LMHC (NPI 1205204401) is an individual counselor in Ithaca, New York and active in the NPI registry since September 2015. She is enrolled in Medicare PECOS and maintains a secondary practice location in Cortland.

NPPES Registry Identity

NPI1205204401

Entity TypeIndividualFemale

Primary Taxonomy101Y00000X

Provider Legal NameANTOINETTE TRISTANCredential: LMHC

Location Address127 W STATE STIthaca, NY 14850-5474

Mailing Address127 W State StIthaca, NY 14850-5474 · (607) 273-7494

Phone(607) 273-7494

Sole ProprietorNo

Enumeration DateSeptember 4, 2015

Last NPPES UpdateDecember 20, 20222 updates tracked since enumeration

NPPES CertifiedDecember 20, 2022

✔ NPI 1205204401 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselorBehavioral Health & Social Service Providers

Taxonomy Code101Y00000X

Definition

A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master's degree and clinical experience and supervision for licensure or certification.

127 W STATE ST, Ithaca, NY 14850

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Secondary Practice Location 1

Location 110 N Main StCortland, NY 13045-2130 · Phone (607) 753-0234 · Fax (607) 299-4349

Other Identifiers 1

Medicaid1336163963NY

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Antoinette Tristan Lmhc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

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Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MS. MARY KATE LENIHAN L.M.F.T.

Marriage & Family Therapist