Individual provider Active NPI

Elizabeth S Carl, LCSW CASAC

  • Clinical Social Worker
  • New City, NY
National Provider Identifier
1194902478
Registry record updated Sep 24, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
R038096 1 Issued in NY
Practice address
356 S Mountain Rd
New City, NY 10956-4514
Phone
(917) 972-8260
Fax
(845) 323-4023
NPI assigned
Jan 29, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 24, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 3817 NY
Clinical Social Worker 1041C0700X R038096 1 NY Primary

Addresses

Primary practice location

356 S Mountain Rd
New City, NY 10956-4514

Mailing address

356 South Mountain Rd
New City, NY 10956-4514
Phone (917) 972-8260

Other identifiers 1

IdentifierTypeStateIssuer
01727251MedicaidNY

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
I20090206000242 NY Practitioner - Clinical Social Worker 2264596253 Practice locations: New City, NY

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

356 S Mountain Rd
New City, NY 10956-4514
Phone (917) 972-8260

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3817NYMDAddiction (Substance Use Disorder) Counselor
R038096 1NYMDClinical Social Worker
038096NYMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1201564800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1537747200000",
    "number": "1194902478",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "356 SOUTH MOUNTAIN RD",
            "city": "NEW CITY",
            "state": "NY",
            "postal_code": "109564514",
            "telephone_number": "917-972-8260",
            "fax_number": "845-323-4023"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "356 S MOUNTAIN RD",
            "city": "NEW CITY",
            "state": "NY",
            "postal_code": "109564514",
            "telephone_number": "917-972-8260",
            "fax_number": "845-323-4023"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARL",
        "first_name": "ELIZABETH",
        "middle_name": "S",
        "name_prefix": "Ms.",
        "credential": "LCSW CASAC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-01-29",
        "last_updated": "2018-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NY",
            "license": "3817",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "R038096 1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01727251",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New City, NY

Sources for this page

Verify at the official NPI Registry.