MRS. KETEVAN GAGNIDZE-MCCORMICK LMHC
NPI 1356661037
Counselor - Mental Health in Newburgh, NY
About Mrs. Ketevan Gagnidze-mccormick Lmhc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
MRS. KETEVAN GAGNIDZE-MCCORMICK LMHC (NPI 1356661037) is an individual mental health provider in Newburgh, New York, licensed in New York (003123) and active in the NPI registry since June 2010. She is enrolled in Medicare PECOS and is a graduate of Other (1985).
NPPES Registry Identity
Specialties & Licenses 3
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Mrs. Ketevan Gagnidze-mccormick Lmhc 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.
Medicare Billing Reassignments
2Medicare enrollment records show Ketevan Gagnidze-mccormick reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Newburgh, NY 12550
- Reassigned Medicare billing, New York enrollment
- 12 clinicians in this Medicare group
Newburgh, NY 12550
- Reassigned Medicare billing, New York enrollment
- 12 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Ketevan Gagnidze-mccormick's NPI number?
The NPI number for Ketevan Gagnidze-mccormick is 1356661037. It was assigned to this individual provider in the NPPES registry on June 4, 2010.
Where is Ketevan Gagnidze-mccormick located?
Ketevan Gagnidze-mccormick practices at 10 Bruce St, Newburgh, NY 12550. The listed phone number is (845) 561-7284.
What is Ketevan Gagnidze-mccormick's specialty?
The primary specialty registered for this NPI is Counselor, specializing in Mental Health, with taxonomy code 101YM0800X.
Is Ketevan Gagnidze-mccormick enrolled in Medicare?
Yes. Ketevan Gagnidze-mccormick is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.
Which organizations bill Medicare for Ketevan Gagnidze-mccormick's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Ketevan Gagnidze-mccormick reassigns Medicare benefits to 2 organizations: Psyprobill, LLC (Newburgh, NY) and Wendy Keller, Lcsw, LLC (Newburgh, NY). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Ketevan Gagnidze-mccormick's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Ketevan Gagnidze-mccormick accept?
Health plans from Oscar Health list Ketevan Gagnidze-mccormick as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
When was this NPI record last updated?
The NPPES record for Ketevan Gagnidze-mccormick was last updated on June 4, 2010. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Mrs. Ketevan Gagnidze-Mccormick, LMHC · NPI 1356661037
Mental Health provider in Newburgh, New York. Individual provider, active in the CMS NPPES registry since June 4, 2010.
## Identity
- **NPI:** 1356661037 (Entity type: Individual)
- **Enumerated:** June 4, 2010
- **Primary specialty:** Counselor - Mental Health · taxonomy 101YM0800X
- **State license:** 003123 (New York)
- **Sole proprietor:** Yes
## Practice location
- **Address:** 10 BRUCE ST, Newburgh, NY 12550-6602
- **Phone:** (845) 561-7284
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment
- **Bills Medicare through:** 2 organizations under Medicare reassignment (form CMS-855R): Psyprobill, LLC (NPI 1184076358, Newburgh, NY); Wendy Keller, Lcsw, LLC (NPI 1982992889, Newburgh, NY) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 1985
## Record status
- **NPPES last updated:** June 4, 2010
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Source: [NPI Profile](https://npiprofile.com/npi/1356661037) · Data from the CMS NPPES public registry.