Active NPI
Venecia Gailan Deroose
- Social Worker
- Auburn, NY
National Provider Identifier
1083348189
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 116962
- Practice address
- 1062 Turnpike Rd
Auburn, NY 13021-9547 - Phone
- (757) 771-4252
- NPI assigned
- Jul 13, 2022
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 116962 | NY | Primary |
Addresses
Primary practice location
1062 Turnpike Rd
Auburn, NY 13021-9547
Mailing address
1062 Turnpike Rd
Auburn, NY 13021-9547
Phone (757) 771-4252
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
| License | State | Type | Specialty |
|---|---|---|---|
| 116962 | NY | MD | Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Bobbi L Petranchuk LCSW PLLC | Past | 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.
-
- Clinical Social Worker
- Evans Mills, NY
- NPI 1982479168
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1657670400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658361600000",
"number": "1083348189",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1062 TURNPIKE RD",
"city": "AUBURN",
"state": "NY",
"postal_code": "130219547",
"telephone_number": "757-771-4252"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1062 TURNPIKE RD",
"city": "AUBURN",
"state": "NY",
"postal_code": "130219547",
"telephone_number": "757-771-4252"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DEROOSE",
"first_name": "VENECIA",
"middle_name": "GAILAN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-07-13",
"last_updated": "2022-07-21",
"certification_date": "2022-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "NY",
"license": "116962",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Auburn, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.