Individual provider Active NPI

Kathleen Ann Webster, LCSWR

  • Clinical Social Worker
  • Elmira, NY
National Provider Identifier
1205937778
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
R069209-1 Issued in NY
Practice address
407 W Water St
Elmira, NY 14905-2521
Phone
(607) 734-0980
Fax
(607) 734-0981
NPI assigned
Sep 26, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X R069209-1 NY Primary

Addresses

Primary practice location

407 W Water St
Elmira, NY 14905-2521

Mailing address

407 W Water St
Elmira, NY 14905-2521
Phone (607) 734-0980

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
I20050622000140 NY Practitioner - Clinical Social Worker 1355392515 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
State University of New York at Buffalo School of Medicine, 1999
Medicare assignment
May accept Medicare assignment
Group practices
Southern Tier Counseling Center LLCGroup PAC ID 1658322805, 4 clinicians

Practice addresses (Care Compare)

550 E Church St
Suite F2
Elmira, NY 14901-2850
Phone (607) 734-0980

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
R069209-1NYMDClinical Social Worker
069209NYMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Southern Tier Counseling Center, LLC Clinical CurrentSince Feb 3, 2005 Accepting new patients

Locations

407 W Water St
Elmira, NY 14905
Phone (607) 734-0980

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1159228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1205937778",
    "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": "149052521",
            "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": "149052521",
            "telephone_number": "607-734-0980",
            "fax_number": "607-734-0981"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEBSTER",
        "first_name": "KATHLEEN",
        "middle_name": "ANN",
        "credential": "LCSWR",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "R069209-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elmira, NY

Sources for this page

Verify at the official NPI Registry.