Individual provider Active NPI

Sharon C. Strack, LCSWR

  • Clinical Social Worker
  • Wappingers Falls, NY
National Provider Identifier
1053676213
Registry record updated Jul 12, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
R047769 Issued in NY
Practice address
1285 Route 9
Suite 7
Wappingers Falls, NY 12590-4993
Phone
(845) 632-2939
Fax
(845) 632-2940
NPI assigned
Jul 12, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 12, 2012

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 R047769 NY Primary

Addresses

Primary practice location

1285 Route 9
Suite 7
Wappingers Falls, NY 12590-4993

Mailing address

1285 Route 9
Suite 7
Wappingers Falls, NY 12590-4993
Phone (845) 632-2939

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
I20130711000534 NY Practitioner - Clinical Social Worker 4789824962 Practice locations: Poughkeepsie, NY

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

11 Raymond Ave
Suite 36
Poughkeepsie, NY 12603-2330
Phone (845) 430-9658

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
R047769NYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Southern Dutchess Psychiatric Consultation PLLC PastSince Feb 27, 2014 Accepting new patients

Organizations & group practices 1

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": "1342051200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1342051200000",
    "number": "1053676213",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1285 ROUTE 9",
            "address_2": "SUITE 7",
            "city": "WAPPINGERS FALLS",
            "state": "NY",
            "postal_code": "125904993",
            "telephone_number": "845-632-2939",
            "fax_number": "845-632-2940"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1285 ROUTE 9",
            "address_2": "SUITE 7",
            "city": "WAPPINGERS FALLS",
            "state": "NY",
            "postal_code": "125904993",
            "telephone_number": "845-632-2939",
            "fax_number": "845-632-2940"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STRACK",
        "first_name": "SHARON",
        "middle_name": "C.",
        "name_prefix": "Ms.",
        "credential": "LCSWR",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-07-12",
        "last_updated": "2012-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "R047769",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wappingers Falls, NY

Sources for this page

Verify at the official NPI Registry.