Abigail J Mack, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

R040569 Issued in NY

Practice address

229-231 State St
Binghamton, NY 13901-2756

Phone

(607) 778-1119

Fax

(607) 778-1164

NPI assigned

Jun 12, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Broome County

  dba Willow Point Nursing Home

  • Skilled Nursing Facility
  • Vestal, NY
  • NPI 1750477923
  NPD (past)
• Broome County Mental Health Department

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Binghamton, NY
  • NPI 1629094065
  NPD (past)

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

{
    "created_epoch": "1150070400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1282867200000",
    "number": "1154363182",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14 GRANDVIEW AVE",
            "city": "CONKLIN",
            "state": "NY",
            "postal_code": "137481215"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "229-231 STATE ST",
            "city": "BINGHAMTON",
            "state": "NY",
            "postal_code": "139012756",
            "telephone_number": "607-778-1119",
            "fax_number": "607-778-1164"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACK",
        "first_name": "ABIGAIL",
        "middle_name": "J",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-12",
        "last_updated": "2010-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "R040569",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "07300040569",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EXCELLUS (BC/BS)",
            "identifier": "000023526",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sarah Lynch, PHARMD
• Emily A Macclary, BS
• James George Macconchie III, MD
• Kathryn Elizabeth Mace, NPP, FNP
• Karen Marie Macey, RN
• Marc Maclaren, RN, BSN, MSN
• Scott Ryan Macnamee, RPA, RRA, RT(R)
• Charles Madrid, RN
• Casper Magacs, PT
• Melissa Ann Magargle, LPN

• Clinical Social Worker in Binghamton, NY
• Providers in Binghamton, 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 Aug 27, 2010; 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.