Individual provider Active NPI

Kathleen Mae Bremer, LCSW-R

  • Local Education Agency (LEA)
  • Canandaigua, NY
National Provider Identifier
1063061695
Registry record updated Sep 6, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Local Education Agency (LEA)Taxonomy code 251300000X
License
070027 Issued in NY
Practice address
96 W Gibson St
Canandaigua, NY 14424-1453
Phone
(585) 396-5703
Fax
(585) 396-3938
NPI assigned
Sep 6, 2019
Last updated
Sep 6, 2019By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 6, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
School Social Worker 1041S0200X 070027 NY
Local Education Agency (LEA) 251300000X 070027 NY Primary

Addresses

Primary practice location

96 W Gibson St
Canandaigua, NY 14424-1453

Mailing address

5150 Emerson Rd
Canandaigua, NY 14424-8089
Phone (585) 278-7475

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
070027NYMDLocal Education Agency (LEA)

NPI Registry JSON

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

{
    "created_epoch": "1567728000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1567728000000",
    "number": "1063061695",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5150 EMERSON RD",
            "city": "CANANDAIGUA",
            "state": "NY",
            "postal_code": "144248089",
            "telephone_number": "585-278-7475",
            "fax_number": "585-396-3938"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "96 W GIBSON ST",
            "city": "CANANDAIGUA",
            "state": "NY",
            "postal_code": "144241453",
            "telephone_number": "585-396-5703",
            "fax_number": "585-396-3938"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BREMER",
        "first_name": "KATHLEEN",
        "middle_name": "MAE",
        "credential": "LCSW-R",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-09-06",
        "last_updated": "2019-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041S0200X",
            "taxonomy_group": "",
            "desc": "Social Worker, School",
            "state": "NY",
            "license": "070027",
            "primary": false
        },
        {
            "code": "251300000X",
            "taxonomy_group": "",
            "desc": "Local Education Agency (LEA)",
            "state": "NY",
            "license": "070027",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Canandaigua, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.