Individual provider Active NPI

Sasha Dora Fassett, LCSW

  • Clinical Social Worker
  • Vestal, NY
National Provider Identifier
1114949062
Registry record updated Jun 8, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
069367 Issued in NY
Practice address
1040 Vestal Pkwy E
Vestal, NY 13850-1748
Phone
(607) 237-5411
Fax
(607) 656-5691
NPI assigned
Jul 23, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 8, 2008

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 069367 NY Primary

Addresses

Primary practice location

1040 Vestal Pkwy E
Vestal, NY 13850-1748

Mailing address

1040 Vestal Pkwy E
Vestal, NY 13850-1748
Phone (607) 237-5411

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
I20070625000442 NY Practitioner - Clinical Social Worker 3173622677 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2001
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

217 Jefferson Ave
Endicott, NY 13760-5244
Phone (607) 242-6850

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
069367NYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Sasha D Fassett Licensed Clinical Social Worker PC Clinical CurrentSince Oct 8, 2017 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": "1153612800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1212883200000",
    "number": "1114949062",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1040 VESTAL PKWY E",
            "city": "VESTAL",
            "state": "NY",
            "postal_code": "138501748",
            "telephone_number": "607-237-5411",
            "fax_number": "607-656-5691"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1040 VESTAL PKWY E",
            "city": "VESTAL",
            "state": "NY",
            "postal_code": "138501748",
            "telephone_number": "607-237-5411",
            "fax_number": "607-656-5691"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FASSETT",
        "first_name": "SASHA",
        "middle_name": "DORA",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-23",
        "last_updated": "2008-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "069367",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vestal, NY

Sources for this page

Verify at the official NPI Registry.