Individual provider Active NPI

Donna C Bjorkman, LCSW

  • Addiction (Substance Use Disorder) Counselor
  • Glens Falls, NY
National Provider Identifier
1003055450
Registry record updated Feb 9, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
029748 Issued in NY
Practice address
55 Elm St
Glens Falls, NY 12801-3549
Phone
(518) 793-7273
Fax
(518) 798-5004
NPI assigned
Feb 9, 2009
Last updated
Feb 9, 2009By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 9, 2009

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 029748 NY Primary

Addresses

Primary practice location

55 Elm St
Glens Falls, NY 12801-3549

Mailing address

PO Box 31904
Hartford, CT 06150-1904
Phone (518) 952-8140

Other identifiers 1

IdentifierTypeStateIssuer
01420800MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090605000276 NY Practitioner - Clinical Social Worker 4587714993 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1983
Medicare assignment
May accept Medicare assignment
Group practices
Karner Psychological Associates PCGroup PAC ID 8224025986, 10 clinicians

Practice addresses (Care Compare)

2280 Western Ave
Guilderland, NY 12084-9210

2280 Western Ave
Suite 1
Guilderland, NY 12084-9206
Phone 5184565056497

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
029748NYMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Senior Living Behavioral Health LCSW PLLC CurrentSince Sep 18, 2023 Accepting new patients
Conifer Park, Inc. Past Accepting new patients
Karner Psychological Associates PC PastSince Mar 1, 1999 Accepting new patients
Conifer Park, Inc. Past Accepting new patients

Locations

4071 Hardt Rd
Eden, NY 14057
Phone (716) 992-4466

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1234137600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1234137600000",
    "number": "1003055450",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 31904",
            "city": "HARTFORD",
            "state": "CT",
            "postal_code": "061501904",
            "telephone_number": "518-952-8140",
            "fax_number": "518-952-8287"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 ELM ST",
            "city": "GLENS FALLS",
            "state": "NY",
            "postal_code": "128013549",
            "telephone_number": "518-793-7273",
            "fax_number": "518-798-5004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BJORKMAN",
        "first_name": "DONNA",
        "middle_name": "C",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-02-09",
        "last_updated": "2009-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NY",
            "license": "029748",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01420800",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Glens Falls, NY

Sources for this page

Verify at the official NPI Registry.