Individual provider Active NPI

Tina Anne Folger, LCSW

  • Clinical Social Worker
  • Vestal, NY
National Provider Identifier
1013017250
Registry record updated May 26, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
R038460-1 Issued in NY
Practice address
217 Raiford Rd
Vestal, NY 13850-3252
Phone
(607) 773-0034
Fax
(607) 770-1916
NPI assigned
Sep 25, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 26, 2020

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 R038460-1 NY Primary

Addresses

Primary practice location

217 Raiford Rd
Vestal, NY 13850-3252

Mailing address

6 Winding LN
Vestal, NY 13850-5426
Phone (607) 773-0034

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
I20081223000619 NY Practitioner - Clinical Social Worker 0840352985 Practice locations: Vestal, NY

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

6 Winding LN
Vestal, NY 13850-5426
Phone (607) 773-0034

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
R038460-1NYMDClinical Social Worker
038460NYMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1159142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1590451200000",
    "number": "1013017250",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6 WINDING LN",
            "city": "VESTAL",
            "state": "NY",
            "postal_code": "138505426",
            "telephone_number": "607-773-0034",
            "fax_number": "607-770-1916"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "217 RAIFORD RD",
            "city": "VESTAL",
            "state": "NY",
            "postal_code": "138503252",
            "telephone_number": "607-773-0034",
            "fax_number": "607-770-1916"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOLGER",
        "first_name": "TINA",
        "middle_name": "ANNE",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-25",
        "last_updated": "2020-05-26",
        "certification_date": "2020-05-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "R038460-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vestal, NY

Sources for this page

Verify at the official NPI Registry.