Individual provider Active NPI

Shirley Hurlburt, LMSW

  • Social Worker
  • Syracuse, NY
National Provider Identifier
1043619661
Registry record updated Aug 19, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
092678 Issued in NY
Practice address
635 James St
Syracuse, NY 13203-2226
Phone
(315) 472-3171
Fax
(315) 671-2977
NPI assigned
Aug 19, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 19, 2014

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 092678 NY Primary

Addresses

Primary practice location

635 James St
Syracuse, NY 13203-2226

Mailing address

635 James St
Syracuse, NY 13203-2226
Phone (315) 472-3171

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
I20220311000227 NY Practitioner - Clinical Social Worker 1951796861 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
092678NYMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Knapp Street Psychiatry, PC CurrentSince Feb 4, 2022 Accepting new patients
Grow Healthcare Group PA CurrentSince Jun 29, 2024 Accepting new patients
Che Senior Psychological Services, PC CurrentSince Feb 4, 2022 Accepting new patients

Locations

1915 Ocean Ave
Brooklyn, NY 11230
Phone (718) 258-7700

300 Cadman Plz W
Fl 12
Brooklyn Heights, NY 11201
Phone (212) 439-7955

250 Beach 17th St
Far Rockaway, NY 11691
Phone (516) 670-0212

165 Broadway
Fl 23
New York, NY 10006
Phone (202) 972-4964

209 Beach 125th St
Rockaway Park, NY 11694
Phone (516) 721-7625

135 Vanderbilt Ave
Staten Island, NY 10304
Phone (718) 447-0101

Organizations & group practices 3

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": "1408406400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1408406400000",
    "number": "1043619661",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "635 JAMES ST",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132032226",
            "telephone_number": "315-472-3171",
            "fax_number": "315-671-2977"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "635 JAMES ST",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132032226",
            "telephone_number": "315-472-3171",
            "fax_number": "315-671-2977"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HURLBURT",
        "first_name": "SHIRLEY",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-08-19",
        "last_updated": "2014-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "092678",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Syracuse, NY

Sources for this page

Verify at the official NPI Registry.