Individual provider Active NPI

Anne M McDonnell, LCSW

  • Clinical Social Worker
  • Ny, NY
National Provider Identifier
1104957539
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
R0303531 Issued in NY
Practice address
25 Minetta Lane
#1C
Ny, NY 10012-1252
Phone
(212) 477-1791
NPI assigned
Mar 8, 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 R0303531 NY Primary

Addresses

Primary practice location

25 Minetta Lane
#1C
Ny, NY 10012-1252

Mailing address

25 Minetta Lane
#1C
Ny, NY 10012-1252
Phone (212) 477-1791

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
I20050225000742 NY Practitioner - Clinical Social Worker 7012960362 Practice locations: New York, NY

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

25 Minetta LN
Apt 1C
New York, NY 10012-1252
Phone (212) 477-1791

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
R0303531NYMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1173312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1104957539",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25 MINETTA LANE",
            "address_2": "#1C",
            "city": "NY",
            "state": "NY",
            "postal_code": "100121252",
            "telephone_number": "212-477-1791"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 MINETTA LANE",
            "address_2": "#1C",
            "city": "NY",
            "state": "NY",
            "postal_code": "100121252",
            "telephone_number": "212-477-1791"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCDONNELL",
        "first_name": "ANNE",
        "middle_name": "M",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-08",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "R0303531",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ny, NY

Sources for this page

Verify at the official NPI Registry.