Individual provider Active NPI

Janice Berry Siracusa, LMSW

  • Social Worker
  • Goshen, NY
National Provider Identifier
1205069341
Registry record updated Aug 24, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
029084 Issued in NY
Practice address
4 Harriman Dr
Goshen, NY 10924-2410
Phone
(845) 294-2265
Fax
(845) 294-2238
NPI assigned
Aug 24, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 24, 2009

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 029084 NY Primary

Addresses

Primary practice location

4 Harriman Dr
Goshen, NY 10924-2410

Mailing address

4 Harriman Dr
Goshen, NY 10924-2410
Phone (845) 294-2265

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
029084NYMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1251072000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1251072000000",
    "number": "1205069341",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 HARRIMAN DR",
            "city": "GOSHEN",
            "state": "NY",
            "postal_code": "109242410",
            "telephone_number": "845-294-2265",
            "fax_number": "845-294-2238"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 HARRIMAN DR",
            "city": "GOSHEN",
            "state": "NY",
            "postal_code": "109242410",
            "telephone_number": "845-294-2265",
            "fax_number": "845-294-2238"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIRACUSA",
        "first_name": "JANICE",
        "middle_name": "BERRY",
        "name_prefix": "Mrs.",
        "credential": "LMSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-08-24",
        "last_updated": "2009-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "029084",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Goshen, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2009; 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.