Active NPI
Edythe Raiten, CSWR, RPT
- Clinical Social Worker
- Monticello, NY
National Provider Identifier
1033277074
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- R039053
- Practice address
- 162 E Broadway
Monticello, NY 12701-8815 - Phone
- (845) 796-1350
- NPI assigned
- Dec 4, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | R039053 | NY | Primary |
Addresses
Primary practice location
162 E Broadway
Monticello, NY 12701-8815
Mailing address
132 Rock Ridge Ave
Monticello, NY 12701-3740
Phone (845) 796-1350
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20040510000476 | NY | Practitioner - Clinical Social Worker | 6305835927 | Practice locations: Monticello, NY |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R039053 | NY | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1165190400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1033277074",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "132 ROCK RIDGE AVE",
"city": "MONTICELLO",
"state": "NY",
"postal_code": "127013740",
"telephone_number": "845-796-1350"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "162 E BROADWAY",
"city": "MONTICELLO",
"state": "NY",
"postal_code": "127018815",
"telephone_number": "845-796-1350"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RAITEN",
"first_name": "EDYTHE",
"credential": "CSWR, RPT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-12-04",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NY",
"license": "R039053",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Monticello, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.