Emmett Rhett Eubanks, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

096062 Issued in NY

Practice address

3967 State Route 149
Fort Ann, NY 12827-4103

Phone

(518) 417-2381

NPI assigned

Nov 7, 2019

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Rachael Elizabeth Eubanks Other name

Electronic endpoints 1

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

Specialty

Clinical Social Worker

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Behavioral Health Services North, Inc.Group PAC ID 3173511557, 68 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Behavioral Health Services North, Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Morrisonville, NY
  • NPI 1689621468
  Medicare reassignment Care Compare group NPD
• Behavioral Health Services North, Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Queensbury, NY
  • NPI 1447005541
  NPD
• Commonsense Wellness Network

  • Community/Behavioral Health Agency
  • Clifton Park, NY
  • NPI 1942879242
  NPD (past)

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

{
    "created_epoch": "1573084800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695168000000",
    "number": "1124663745",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3967 STATE ROUTE 149",
            "city": "FORT ANN",
            "state": "NY",
            "postal_code": "128274103",
            "telephone_number": "518-417-2381"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3967 STATE ROUTE 149",
            "city": "FORT ANN",
            "state": "NY",
            "postal_code": "128274103",
            "telephone_number": "518-417-2381"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "75 Railroad Pl",
            "address_purpose": "LOCATION",
            "city": "Saratoga Springs",
            "state": "NY",
            "postal_code": "128662124",
            "country_code": "US",
            "telephone_number": "518-545-4691",
            "fax_number": "518-704-4727",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "EUBANKS",
        "first_name": "EMMETT",
        "middle_name": "RHETT",
        "name_prefix": "Mr.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-11-07",
        "last_updated": "2023-09-20",
        "certification_date": "2023-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "096062",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "rhett@raialbany.com",
            "affiliation": "N",
            "endpointDescription": "Work Email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "10 Colvin Ave Ste 106",
            "city": "Albany",
            "state": "NY",
            "country_code": "US",
            "postal_code": "122061242",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "RACHAEL",
            "last_name": "EUBANKS",
            "middle_name": "ELIZABETH",
            "credential": "LMSW",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Fort Ann Central School
• Fort Ann Rescue Squad Inc
• Suzanne Marie Loparnos, M.S., CCC-SLP
• Jesse Matteson, OTR/L
• Rachel McQueen, M.S., LCAT, MT-BC

• Clinical Social Worker in Fort Ann, NY
• Providers in Fort Ann, NY by specialty
• Clinical Social Worker in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2023; 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.

Verify at the official NPI Registry.