ETHAN BARDELL
NPI 1215583067
Counselor in Cortland, NY

Q: What is Ethan Bardell's NPI number?

The NPI number for Ethan Bardell is 1215583067. It was assigned to this individual provider in the NPPES registry on August 16, 2019.

Q: What is Ethan Bardell's specialty?

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

Q: When was this NPI record last updated?

The NPPES record for Ethan Bardell was last updated on August 16, 2019. NPI Profile syncs with the weekly NPPES data releases published by CMS.

Active since August 16, 2019PECOS EnrolledAccepts Medicare Assignment

165 MAIN ST, STE A, CORTLAND, NY 13045(607) 753-0234 Get Directions Write a Review

NPPES record last updated: August 16, 2019. Verified against the NPPES registry weekly; last sync: July 26, 2026.

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About Ethan Bardell NPPES

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

ETHAN BARDELL (NPI 1215583067) is an individual counselor in Cortland, New York, licensed in New York (101837) and active in the NPI registry since August 2019. He is enrolled in Medicare PECOS and is a graduate of Other (2018).

NPPES Registry Identity

NPI1215583067

Entity TypeIndividualMale

Primary Taxonomy101Y00000X

Provider Legal NameETHAN BARDELL

Location Address165 MAIN ST, STE ACortland, NY 13045-3049

Mailing Address165 Main St, Ste ACortland, NY 13045-3049 · (607) 753-0234

Phone(607) 753-0234

Sole ProprietorNo

Medical School CMSOtherGraduated 2018

Enumeration DateAugust 16, 2019

✔ NPI 1215583067 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselorBehavioral Health & Social Service Providers

Taxonomy Code101Y00000X

License✔ Licensed in NY · 101837

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.

165 MAIN ST, Cortland, NY 13045

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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Ethan Bardell is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID4385096866

PECOS Enrollment IDI20240119003247

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.

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.

CHARLOTTE SWEENEY LCSW

Counselor