Individual provider Active NPI

Heather A Reynolds, LCSW

  • Clinical Social Worker
  • Utica, NY
National Provider Identifier
1003153370
Registry record updated Jun 20, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
084157 Issued in NY
Practice address
628 Mary St
Utica, NY 13501-2419
Phone
(315) 272-2700
NPI assigned
Jan 7, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 20, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 084157 NY Primary

Addresses

Primary practice location

628 Mary St
Utica, NY 13501-2419

Mailing address

628 Mary St
Utica, NY 13501-2419
Phone (315) 272-2700

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
I20190619002466 NY Practitioner - Clinical Social Worker 2567796949 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Neighborhood Center, IncGroup PAC ID 3678619897, 10 clinicians

Practice addresses (Care Compare)

628 Mary St
Utica, NY 13501-2419
Phone (315) 272-2700

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
084157NYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
The Neighborhood Center, Inc. Clinical CurrentSince Jun 5, 2019 Accepting new patients

Locations

624 Elizabeth St
Utica, NY 13501
Phone (315) 272-2600

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1357516800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1497916800000",
    "number": "1003153370",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "628 MARY ST",
            "city": "UTICA",
            "state": "NY",
            "postal_code": "135012419",
            "telephone_number": "315-272-2700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "628 MARY ST",
            "city": "UTICA",
            "state": "NY",
            "postal_code": "135012419",
            "telephone_number": "315-272-2700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REYNOLDS",
        "first_name": "HEATHER",
        "middle_name": "A",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-01-07",
        "last_updated": "2017-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "084157",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Utica, NY

Sources for this page

Verify at the official NPI Registry.