Individual provider Active NPI

Debra Terry

  • Clinical Social Worker
  • Bay Shore, NY
National Provider Identifier
1073717765
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
074977 Issued in NY
Practice address
260 W Main St
Suite 8
Bay Shore, NY 11706-8322
Phone
(631) 647-9009
NPI assigned
Jun 14, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 074977 NY Primary

Addresses

Primary practice location

260 W Main St
Suite 8
Bay Shore, NY 11706-8322

Mailing address

23 Elkin Dr
Middle Island, NY 11953-2110
Phone (631) 775-6032

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
I20070913000093 NY Practitioner - Clinical Social Worker 0547354144 Reassigns benefits to 3 organizations
Practice locations: Patchogue, NY; Riverhead, NY

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Laura E Asner CSW PCGroup PAC ID 3577525740, 6 clinicians

Practice addresses (Care Compare)

260 W Main St
Suite 8
Bay Shore, NY 11706-8322
Phone (631) 647-9009

4 Phyllis Dr
Suite G
Patchogue, NY 11772-2900
Phone (631) 882-2940

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Family Service League, Inc. CurrentSince Aug 16, 2012 Accepting new patients
Laura E Asner CSW PC Clinical CurrentSince Jul 7, 2015 Accepting new patients
Debra L. Terry LCSW, P.C. CurrentSince Jun 23, 2020 Accepting new patients
Metropolitan Psychological & Licensed Master Social Work Services PLLC Clinical PastSince Jul 7, 2015 Accepting new patients

Locations

260 W Main St
Ste 8
Bay Shore, NY 11706
Phone (631) 647-9009

790 Park Ave
Huntington, NY 11743
Phone (631) 427-3700

4 Phyllis Dr
Ste G
Patchogue, NY 11772
Phone (631) 203-6202

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H3359

Organizations & group practices 4

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": "1181779200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1073717765",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23 ELKIN DR",
            "city": "MIDDLE ISLAND",
            "state": "NY",
            "postal_code": "119532110",
            "telephone_number": "631-775-6032"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "260 W MAIN ST",
            "address_2": "SUITE 8",
            "city": "BAY SHORE",
            "state": "NY",
            "postal_code": "117068322",
            "telephone_number": "631-647-9009"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TERRY",
        "first_name": "DEBRA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-14",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "074977",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bay Shore, NY

Sources for this page

Verify at the official NPI Registry.