Individual provider Active NPI

Kelly Ann Sarnowski, LCSW

  • Clinical Social Worker
  • Bangor, PA
National Provider Identifier
1114069101
Registry record updated Aug 10, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
CW016370 Issued in PA
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

Updated by the provider on Aug 10, 2009

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 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

IdentifierTypeStateIssuer
50064513OtherPACAPITAL 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

LicenseStateTypeSpecialty
44SL05404000NJMDSocial Worker
CW016370PAMDClinical 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.

Verify at the official NPI Registry.