Individual provider Active NPI

Linda Ryan, LCSW

  • Clinical Social Worker
  • West Harrison, NY
National Provider Identifier
1104222975
Registry record updated Dec 29, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
093175-01 Issued in NY
Practice address
105 Corporate Park Dr
#3050
West Harrison, NY 10604-3331
Phone
(914) 873-1087
NPI assigned
Nov 6, 2014
Last updated
Dec 29, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 29, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X
Clinical Social Worker 1041C0700X 093175-01 NY Primary

Addresses

Primary practice location

105 Corporate Park Dr
#3050
West Harrison, NY 10604-3331

Mailing address

105 Corporate Park Dr Apt 3050
West Harrison, NY 10604-3331
Phone (914) 873-1087

Other practice location 1

343 Manville Rd Ste 3U
Pleasantville, NY 10570-2153
Phone (914) 873-1087

Other practice location 2

1156 N Broadway
Yonkers, NY 10701-1108
Phone (914) 965-3700 ext. 1295

Other identifiers 3

IdentifierTypeStateIssuer
WVE061OtherNYMEDICARE #
02449154OtherNYMEDICAID #
1285628552OtherNYAGENCY

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
093175-01NYMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1415232000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703808000000",
    "number": "1104222975",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 CORPORATE PARK DR APT 3050",
            "city": "WEST HARRISON",
            "state": "NY",
            "postal_code": "106043331",
            "telephone_number": "914-873-1087"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 CORPORATE PARK DR",
            "address_2": "#3050",
            "city": "WEST HARRISON",
            "state": "NY",
            "postal_code": "106043331",
            "telephone_number": "914-873-1087"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "343 Manville Rd Ste 3U",
            "address_purpose": "LOCATION",
            "city": "Pleasantville",
            "state": "NY",
            "postal_code": "105702153",
            "country_code": "US",
            "telephone_number": "914-873-1087",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1156 N Broadway",
            "address_purpose": "LOCATION",
            "city": "Yonkers",
            "state": "NY",
            "postal_code": "107011108",
            "country_code": "US",
            "telephone_number": "914-965-3700 x1295",
            "fax_number": "914-798-5549",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RYAN",
        "first_name": "LINDA",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-11-06",
        "last_updated": "2023-12-29",
        "certification_date": "2022-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "093175-01",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE #",
            "identifier": "WVE061",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID #",
            "identifier": "02449154",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AGENCY",
            "identifier": "1285628552",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in West Harrison, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2023; 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.