Individual provider Active NPI

Tiffany St. Louis, L.C.S.W

  • Clinical Social Worker
  • Glens Falls, NY
National Provider Identifier
1003209362
Registry record updated Dec 27, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
085439-1 Issued in NY
Practice address
1 Lawrence St
Glens Falls, NY 12801-3617
Phone
(518) 926-7067
NPI assigned
Mar 11, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 27, 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 085439-1 NY Primary

Addresses

Primary practice location

1 Lawrence St
Glens Falls, NY 12801-3617

Mailing address

229 Bay Rd Apt 1
Glens Falls, NY 12801-2357
Phone (518) 929-3630

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
I20180716000575 NY Practitioner - Clinical Social Worker 1557618071 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
085439-1NYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Saratoga Center for the Family CurrentSince Jun 1, 2018 Accepting new patients

Locations

105 Oak St
Corinth, NY 12822
Phone (518) 654-2960

359 Ballston Ave
Saratoga Springs, NY 12866
Phone (518) 583-9262

99 Hudson St
South Glens Falls, NY 12803
Phone (518) 792-5891

42 Merritt Rd
South Glens Falls, NY 12803

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": "1426032000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1514332800000",
    "number": "1003209362",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "229 BAY RD APT 1",
            "city": "GLENS FALLS",
            "state": "NY",
            "postal_code": "128012357",
            "telephone_number": "518-929-3630"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 LAWRENCE ST",
            "city": "GLENS FALLS",
            "state": "NY",
            "postal_code": "128013617",
            "telephone_number": "518-926-7067"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ST. LOUIS",
        "first_name": "TIFFANY",
        "credential": "L.C.S.W",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-03-11",
        "last_updated": "2017-12-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "085439-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glens Falls, NY

Sources for this page

Verify at the official NPI Registry.