Individual provider Active NPI

Sandra Lynn Radford, LCSW-R

  • Clinical Social Worker
  • Auburn, NY
National Provider Identifier
1043406523
Registry record updated Jan 29, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
73 075948 Issued in NY
Practice address
180 North St
Auburn, NY 13021-1811
Phone
(315) 567-0129
Fax
(315) 255-0852
NPI assigned
Sep 19, 2007
Last updated
Jan 29, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 29, 2014

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 73 075948 NY Primary

Addresses

Primary practice location

180 North St
Auburn, NY 13021-1811

Mailing address

180 North St
Auburn, NY 13021-1811
Phone (315) 567-0129

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
I20071004000618 NY Practitioner - Clinical Social Worker 3870688997 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1521 Clark St Rd
Auburn, NY 13021-9526
Phone (315) 253-7331

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
73 075948NYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Presence Sealy Counseling and Development Licensedclinicalservicespllc Clinical CurrentSince Jan 5, 2019 Accepting new patients
Seneca Cayuga Counties Chapter Nysarc, Inc. CurrentSince Jul 18, 2011 Accepting new patients
Presence Psychology, LMSW, PT, OT and SLP Services, PLLC CurrentSince Jan 5, 2019 Accepting new patients
Seneca Cayuga Counties Chapter Nysarc, Inc. Past Accepting new patients

Locations

1521 Clark Street Rd
Auburn, NY 13021
Phone (315) 253-7331

115 Fall St
Seneca Falls, NY 13148
Phone (315) 515-5183

1083 Waterloo Geneva Rd
Waterloo, NY 13165
Phone (315) 539-4049

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/CJEBCD/Endpoint/CJEBCD

Organizations & group practices 4

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

NPI Registry JSON

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

{
    "created_epoch": "1190160000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1390953600000",
    "number": "1043406523",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "180 NORTH ST",
            "city": "AUBURN",
            "state": "NY",
            "postal_code": "130211811",
            "telephone_number": "315-567-0129",
            "fax_number": "315-255-0852"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "180 NORTH ST",
            "city": "AUBURN",
            "state": "NY",
            "postal_code": "130211811",
            "telephone_number": "315-567-0129",
            "fax_number": "315-255-0852"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RADFORD",
        "first_name": "SANDRA",
        "middle_name": "LYNN",
        "name_prefix": "Ms.",
        "credential": "LCSW-R",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-09-19",
        "last_updated": "2014-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "73 075948",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Auburn, NY

Sources for this page

Verify at the official NPI Registry.