Individual provider Active NPI

Danielle Eadie, LCSW

  • Clinical Social Worker
  • Tonawanda, NY
National Provider Identifier
1053061192
Registry record updated Mar 23, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
087791-01 Issued in NY
Practice address
884 Brighton Rd
Tonawanda, NY 14150-8169
Phone
(716) 836-9460
NPI assigned
Mar 23, 2022
Last updated
Mar 23, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 23, 2022

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 087791-01 NY Primary

Addresses

Primary practice location

884 Brighton Rd
Tonawanda, NY 14150-8169

Mailing address

884 Brighton Rd
Tonawanda, NY 14150-8169

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
I20240717000952 NY Practitioner - Clinical Social Worker 8123563921 Practice locations: Tonawanda, NY

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
087791-01NYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Danielle S. Eadie LCSW PLLC Clinical Current Accepting new patients
Watson Psychological Services, PLLC PastSince Feb 12, 2017 Accepting new patients

Locations

884 Brighton Rd
Tonawanda, NY 14150
Phone (716) 536-9460

Organizations & group practices 2

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": "1647993600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1647993600000",
    "number": "1053061192",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "884 BRIGHTON RD",
            "city": "TONAWANDA",
            "state": "NY",
            "postal_code": "141508169"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "884 BRIGHTON RD",
            "city": "TONAWANDA",
            "state": "NY",
            "postal_code": "141508169",
            "telephone_number": "716-836-9460"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EADIE",
        "first_name": "DANIELLE",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-03-23",
        "last_updated": "2022-03-23",
        "certification_date": "2022-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "087791-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tonawanda, NY

Sources for this page

Verify at the official NPI Registry.