Individual provider Active NPI

Stephanie Jeanette Mannion Ngelezi

  • Social Worker
  • Latham, NY
National Provider Identifier
1063964054
Registry record updated Jul 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
097658-1 Issued in NY
Practice address
3 Lear Jet LN Ste 104N
Latham, NY 12110-2314
Phone
(518) 560-4277
NPI assigned
Oct 26, 2016
Last updated
Jul 22, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 22, 2024

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 097658-1 NY Primary

Addresses

Primary practice location

3 Lear Jet LN Ste 104N
Latham, NY 12110-2314

Mailing address

504 Foxwood Dr
Clifton Park, NY 12065-6928
Phone (845) 616-6008

Other practice location 1

614 Cooper Hill Rd
Wynantskill, NY 12198-2906
Phone (518) 283-6500 ext. 747

Other names 1

  • Stephanie Mannion Former name

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
I20250527003143 NY Practitioner - Clinical Social Worker 3870012420 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
097658-1NYMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Parsons Child and Family Center CurrentSince Apr 14, 2025 Accepting new patients

Locations

60 Academy Rd
Albany, NY 12208
Phone (518) 292-5499

401 New Karner Rd
Colonie, NY 12205
Phone (518) 456-3614

375 Bay Rd
Queensbury, NY 12804
Phone (518) 741-0043

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, 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": "1477440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721606400000",
    "number": "1063964054",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "504 FOXWOOD DR",
            "city": "CLIFTON PARK",
            "state": "NY",
            "postal_code": "120656928",
            "telephone_number": "845-616-6008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 LEAR JET LN STE 104N",
            "city": "LATHAM",
            "state": "NY",
            "postal_code": "121102314",
            "telephone_number": "518-560-4277"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "614 Cooper Hill Rd",
            "address_purpose": "LOCATION",
            "city": "Wynantskill",
            "state": "NY",
            "postal_code": "121982906",
            "country_code": "US",
            "telephone_number": "518-283-6500 x747",
            "fax_number": "518-286-2132",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NGELEZI",
        "first_name": "STEPHANIE",
        "middle_name": "JEANETTE MANNION",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-10-26",
        "last_updated": "2024-07-22",
        "certification_date": "2024-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "097658-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "STEPHANIE",
            "last_name": "MANNION",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Latham, NY

Sources for this page

Verify at the official NPI Registry.