ALISSA BLAKE WALRUTH LMHC-D
NPI 1629758404
Counselor - Mental Health in Penn Yan, NY
About Alissa Blake Walruth Lmhc-d NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
ALISSA BLAKE WALRUTH LMHC-D (NPI 1629758404) is an individual mental health provider in Penn Yan, New York, licensed in New York (013651) and active in the NPI registry since July 2023. She is enrolled in Medicare PECOS, maintains a secondary practice location in Corning, and is a graduate of Other (2020).
NPPES Registry Identity
Specialties & Licenses 2
Secondary Practice Location 1
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Alissa Blake Walruth Lmhc-d is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Other Providers at the Same Location NPPES 12
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
PENN YAN, NY 14527
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 Alissa Walruth's NPI number?
The NPI number for Alissa Walruth is 1629758404. It was assigned to this individual provider in the NPPES registry on July 18, 2023.
Where is Alissa Walruth located?
Alissa Walruth practices at 3 School Dr, Penn Yan, NY 14527. The listed phone number is (315) 924-6050.
What is Alissa Walruth's specialty?
The primary specialty registered for this NPI is Counselor, specializing in Mental Health, with taxonomy code 101YM0800X.
Is Alissa Walruth enrolled in Medicare?
Yes. Alissa Walruth is registered in the Medicare PECOS enrollment system.
When was this NPI record last updated?
The NPPES record for Alissa Walruth was last updated on July 15, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 26 days 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.
# Alissa Blake Walruth, LMHC-D · NPI 1629758404
Mental Health provider in Penn Yan, New York. Individual provider, active in the CMS NPPES registry since July 18, 2023.
## Identity
- **NPI:** 1629758404 (Entity type: Individual)
- **Enumerated:** July 18, 2023
- **Primary specialty:** Counselor - Mental Health · taxonomy 101YM0800X
- **State license:** 013651 (New York)
- **Sole proprietor:** No
## Practice location
- **Address:** 3 SCHOOL DR, Penn Yan, NY 14527-1081
- **Phone:** (315) 924-6050
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment
- **Medical school:** Other, class of 2020
## Record status
- **NPPES last updated:** July 15, 2026
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Source: [NPI Profile](https://npiprofile.com/npi/1629758404) · Data from the CMS NPPES public registry.