Active NPI
Thomas Christopher Stephens, LCSW
- Social Worker
- Olean, NY
National Provider Identifier
1104995018
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- R0415881
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 01906532 | Medicaid | NY |
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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
| License | State | Type | Specialty |
|---|---|---|---|
| R0415881 | NY | MD | Social Worker |
| 041588 | NY | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Cattaraugus Rehabilitation Center, Inc. | 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.
-
- Developmental Disabilities Clinic/Center
- Olean, NY
- NPI 1316132533
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.