Individual provider Active NPI

Lilah J Crelley, LMSW

  • Social Worker
  • Canandaigua, NY
National Provider Identifier
1144508045
Registry record updated Jul 26, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
069797 Issued in NY
Practice address
3019 County Complex Dr
Canandaigua, NY 14424-9505
Phone
(585) 396-4363
Fax
(585) 396-4993
NPI assigned
Jul 26, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 26, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 069797 NY Primary

Addresses

Primary practice location

3019 County Complex Dr
Canandaigua, NY 14424-9505

Mailing address

3019 County Complex Dr
Canandaigua, NY 14424-9505
Phone (585) 396-4363

Other identifiers 1

IdentifierTypeStateIssuer
02249154MedicaidNY

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
I20111018000169 NY Practitioner - Clinical Social Worker 6709058795 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
069797NYMDClinical Social Worker

Interoperability endpoints

  • Direct secure messaging: lcrelley@ontariocountymentalhealth.direct.rrhio.org
  • Direct secure messaging: ocmhc@ontariocountymentalhealth.direct.rrhio.org

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": "1311638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1311638400000",
    "number": "1144508045",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3019 COUNTY COMPLEX DR",
            "city": "CANANDAIGUA",
            "state": "NY",
            "postal_code": "144249505",
            "telephone_number": "585-396-4363",
            "fax_number": "585-396-4993"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3019 COUNTY COMPLEX DR",
            "city": "CANANDAIGUA",
            "state": "NY",
            "postal_code": "144249505",
            "telephone_number": "585-396-4363",
            "fax_number": "585-396-4993"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRELLEY",
        "first_name": "LILAH",
        "middle_name": "J",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-07-26",
        "last_updated": "2011-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "069797",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02249154",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Canandaigua, NY

Sources for this page

Verify at the official NPI Registry.