George Funnell

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

069585 Issued in NY

Practice address

407 W Water St
Elmira, NY 14905-2562

Phone

(607) 734-0980

Fax

(607) 734-0981

NPI assigned

Sep 11, 2018

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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, 1996

Medicare assignment

May accept Medicare assignment

Group practices

Southern Tier Counseling Center LLCGroup PAC ID 1658322805, 4 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Southern Tier Counseling Center, LLC

  • Clinical Social Worker
  • Elmira, NY
  • NPI 1598716292
  Medicare reassignment Care Compare group NPD
• Samaritan Counseling Center of the Southern Tier Inc

  • Mental Health Counselor
  • Endicott, NY
  • NPI 1467520080

  Clinical

  Medicare reassignment NPD

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

{
    "created_epoch": "1536624000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1536624000000",
    "number": "1154804581",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "407 W WATER ST",
            "city": "ELMIRA",
            "state": "NY",
            "postal_code": "149052562",
            "telephone_number": "607-734-0980",
            "fax_number": "607-734-0981"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "407 W WATER ST",
            "city": "ELMIRA",
            "state": "NY",
            "postal_code": "149052562",
            "telephone_number": "607-734-0980",
            "fax_number": "607-734-0981"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FUNNELL",
        "first_name": "GEORGE",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-09-11",
        "last_updated": "2018-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "069585",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Valerie Frisk, LCSW
• Shirley Ann Fritz
• Alexandria Frutchey
• Angela Frycek, R.N.
• Christopher Daniel Fucito, D.O.
• Bobbi Rae Furnas, MED, PT
• Janet Fusare
• Deepakraj Gajanana, M.D
• Anne Galbraith, M.C.D., CCC-SLP
• Renee Gallagher, LCSW

• Clinical Social Worker in Elmira, NY
• Providers in Elmira, 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 11, 2018; 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.