Individual provider Active NPI

Thomas Christopher Stephens, LCSW

  • Social Worker
  • Olean, NY
National Provider Identifier
1104995018
Registry record updated Feb 9, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
R0415881 Issued in NY
Practice address
237 Delaware Avenue
Delaware Executive Office Suites, Suite 11
Olean, NY 14760
Phone
(716) 378-7210
NPI assigned
Nov 6, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 9, 2010

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 R0415881 NY Primary
Mental Health Counselor 101YM0800X R0415881 NY

Addresses

Primary practice location

237 Delaware Avenue
Delaware Executive Office Suites, Suite 11
Olean, NY 14760

Mailing address

237 Delaware Avenue
Delaware Executive Office Suites, Suite 11
Olean, NY 14760
Phone (716) 378-7210

Other identifiers 1

IdentifierTypeStateIssuer
01906532MedicaidNY

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
I20090529000326 NY Practitioner - Clinical Social Worker 9537218227 Practice locations: Olean, NY

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

114 S 10TH St
Olean, NY 14760-3302
Phone (716) 378-7210

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
R0415881NYMDSocial Worker
041588NYMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Cattaraugus Rehabilitation Center, Inc. PastSince Sep 10, 2014 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.

NPI Registry JSON

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

{
    "created_epoch": "1162771200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1265673600000",
    "number": "1104995018",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "237 DELAWARE AVENUE",
            "address_2": "DELAWARE EXECUTIVE OFFICE SUITES, SUITE 11",
            "city": "OLEAN",
            "state": "NY",
            "postal_code": "14760",
            "telephone_number": "716-378-7210"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "237 DELAWARE AVENUE",
            "address_2": "DELAWARE EXECUTIVE OFFICE SUITES, SUITE 11",
            "city": "OLEAN",
            "state": "NY",
            "postal_code": "14760",
            "telephone_number": "716-378-7210"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEPHENS",
        "first_name": "THOMAS",
        "middle_name": "CHRISTOPHER",
        "name_prefix": "Mr.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-06",
        "last_updated": "2010-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "R0415881",
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NY",
            "license": "R0415881",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01906532",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Olean, NY

Sources for this page

Verify at the official NPI Registry.