Individual provider Active NPI

Heather Kayson Hubeny, LCSWR

  • Clinical Social Worker
  • Endicott, NY
National Provider Identifier
1124372263
Registry record updated Jul 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
083833 Issued in NY
Practice address
56 Washington Ave Ste 204
Endicott, NY 13760-5305
Phone
(607) 205-8528
Fax
(607) 348-1742
NPI assigned
Oct 26, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 26, 2023

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 083833 NY Primary

Addresses

Primary practice location

56 Washington Ave Ste 204
Endicott, NY 13760-5305

Mailing address

56 Washington Ave Ste 204
Endicott, NY 13760-5305
Phone (607) 205-8528

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
I20170726002852 NY Practitioner - Clinical Social Worker 2567732381 Practice locations: Endicott, NY

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1100 E Main St
Endicott, NY 13760-5254
Phone (607) 205-8528

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
083833NYMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1351209600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690329600000",
    "number": "1124372263",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "56 WASHINGTON AVE STE 204",
            "city": "ENDICOTT",
            "state": "NY",
            "postal_code": "137605305",
            "telephone_number": "607-205-8528",
            "fax_number": "607-348-1742"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "56 WASHINGTON AVE STE 204",
            "city": "ENDICOTT",
            "state": "NY",
            "postal_code": "137605305",
            "telephone_number": "607-205-8528",
            "fax_number": "607-348-1742"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUBENY",
        "first_name": "HEATHER",
        "middle_name": "KAYSON",
        "credential": "LCSWR",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-10-26",
        "last_updated": "2023-07-26",
        "certification_date": "2023-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "083833",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Endicott, NY

Sources for this page

Verify at the official NPI Registry.