Individual provider Active NPI

Kathleen Sprague, LCSW

  • Social Worker
  • Burnt Hills, NY
National Provider Identifier
1184913576
Registry record updated Feb 26, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
Practice address
88 Lake Hill Rd
Burnt Hills, NY 12027-9598
Phone
(518) 399-9141
NPI assigned
Apr 6, 2011
Last updated
Feb 26, 2015By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 26, 2015

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 Primary

Addresses

Primary practice location

88 Lake Hill Rd
Burnt Hills, NY 12027-9598

Mailing address

50 Cypress Dr
Glenville, NY 12302-4344
Phone (518) 399-9141

Other identifiers 1

IdentifierTypeStateIssuer
00318805MedicaidNY

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
I20230329001211 NY Practitioner - Clinical Social Worker 3173997384 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Columbia CountyGroup PAC ID 8022003409, 16 clinicians

Practice addresses (Care Compare)

325 Columbia St
Suite 300
Hudson, NY 12534-1931
Phone (518) 828-9446

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Columbia County CurrentSince Apr 17, 2023 Accepting new patients
Columbia County CurrentSince Apr 17, 2023 Accepting new patients
Burnt Hills-Ballston Lake Central School District Past Accepting new patients

Locations

325 Columbia St
Hudson, NY 12534

325 Columbia St
Ste 300
Hudson, NY 12534
Phone 51882894461213

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1302048000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1424908800000",
    "number": "1184913576",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50 CYPRESS DR",
            "city": "GLENVILLE",
            "state": "NY",
            "postal_code": "123024344",
            "telephone_number": "518-399-9141"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "88 LAKE HILL RD",
            "city": "BURNT HILLS",
            "state": "NY",
            "postal_code": "120279598",
            "telephone_number": "518-399-9141"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPRAGUE",
        "first_name": "KATHLEEN",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-04-06",
        "last_updated": "2015-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00318805",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Burnt Hills, NY

Sources for this page

Verify at the official NPI Registry.