Individual provider Active NPI

Heather McManaman, LCSW

  • Clinical Social Worker
  • Watertown, NY
National Provider Identifier
1073062378
Registry record updated Sep 27, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
084779 Issued in NY
Practice address
25706 Hinds Rd
Watertown, NY 13601-5150
Phone
(315) 782-5191
NPI assigned
Sep 27, 2016
Last updated
Sep 27, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 27, 2016

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 084779 NY Primary

Addresses

Primary practice location

25706 Hinds Rd
Watertown, NY 13601-5150

Mailing address

25706 Hinds Rd
Watertown, NY 13601-5150
Phone (315) 782-5191

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
I20170208001099 NY Practitioner - Clinical Social Worker 2466735907 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Rubenzahl, Knudsen and Associates Psych., Srvcs, P.C.Group PAC ID 2860461076, 3 clinicians

Practice addresses (Care Compare)

22670 Summit Dr
Suite 2
Watertown, NY 13601-7208
Phone (315) 788-3332

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
084779NYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Rubenzahl, Knudsen & Associates Psych., Srvcs, P.C. CurrentSince Dec 31, 2016 Accepting new patients

Locations

22670 Summit Dr
Ste 2
Watertown, NY 13601
Phone (315) 772-3332

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": "1474934400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1474934400000",
    "number": "1073062378",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25706 HINDS RD",
            "city": "WATERTOWN",
            "state": "NY",
            "postal_code": "136015150",
            "telephone_number": "315-782-5191"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25706 HINDS RD",
            "city": "WATERTOWN",
            "state": "NY",
            "postal_code": "136015150",
            "telephone_number": "315-782-5191"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCMANAMAN",
        "first_name": "HEATHER",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-09-27",
        "last_updated": "2016-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "084779",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Watertown, NY

Sources for this page

Verify at the official NPI Registry.