Individual provider Active NPI

Cynthia May Chase, LCSW, MS

  • Clinical Social Worker
  • Yonkers, NY
National Provider Identifier
1043335805
Registry record updated Jul 8, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
000842 Issued in CT
Practice address
1 Abbey PL
Yonkers, NY 10701-1715
Phone
(860) 395-0284
Fax
(914) 410-3472
NPI assigned
Mar 20, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2015

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 000842 CT Primary

Addresses

Primary practice location

1 Abbey PL
Yonkers, NY 10701-1715

Mailing address

1 Abbey PL
Yonkers, NY 10701-1715
Phone (860) 395-0284

Other identifiers 3

IdentifierTypeStateIssuer
004195170MedicaidCT
140000842CT03OtherCTANTHEM
4195170OtherCOCT MEDICAL ASSISTANCE PRO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
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
I20050623000455 CT Practitioner - Clinical Social Worker 1658316294 Practice locations: Old Saybrook, CT

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
000842CTMDOccupational Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1174348800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1436313600000",
    "number": "1043335805",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 ABBEY PL",
            "city": "YONKERS",
            "state": "NY",
            "postal_code": "107011715",
            "telephone_number": "860-395-0284",
            "fax_number": "914-410-3472"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 ABBEY PL",
            "city": "YONKERS",
            "state": "NY",
            "postal_code": "107011715",
            "telephone_number": "860-395-0284",
            "fax_number": "914-410-3472"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHASE",
        "first_name": "CYNTHIA",
        "middle_name": "MAY",
        "name_prefix": "Ms.",
        "credential": "LCSW, MS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-20",
        "last_updated": "2015-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "000842",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004195170",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "140000842CT03",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CT MEDICAL ASSISTANCE PRO",
            "identifier": "4195170",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Yonkers, NY

Sources for this page

Verify at the official NPI Registry.