Active NPI
Kelly Ann Sarnowski, LCSW
- Clinical Social Worker
- Bangor, PA
National Provider Identifier
1114069101
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- CW016370
- Practice address
- 51 Market St
Bangor, PA 18013-1901 - Phone
- (610) 588-9109
- Fax
- (610) 588-5016
- NPI assigned
- Feb 13, 2007
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 44SL05404000 | NJ | |
| Clinical Social Worker | 1041C0700X | CW016370 | PA | Primary |
Addresses
Primary practice location
51 Market St
Bangor, PA 18013-1901
Mailing address
94 Johnson Rd
Bangor, PA 18013-9238
Phone (610) 599-3115
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 50064513 | Other | PA | CAPITAL BLUE CROSS |
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 44SL05404000 | NJ | MD | Social Worker |
| CW016370 | PA | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1171324800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1249862400000",
"number": "1114069101",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "94 JOHNSON RD",
"city": "BANGOR",
"state": "PA",
"postal_code": "180139238",
"telephone_number": "610-599-3115"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "51 MARKET ST",
"city": "BANGOR",
"state": "PA",
"postal_code": "180131901",
"telephone_number": "610-588-9109",
"fax_number": "610-588-5016"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SARNOWSKI",
"first_name": "KELLY",
"middle_name": "ANN",
"name_prefix": "Mrs.",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-02-13",
"last_updated": "2009-08-10",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "NJ",
"license": "44SL05404000",
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "PA",
"license": "CW016370",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CAPITAL BLUE CROSS",
"identifier": "50064513",
"state": "PA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Bangor, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.