Active NPI
Terry L Twichell, MSW LCSWR
- Clinical Social Worker
- Fayetteville, NY
National Provider Identifier
1215059159
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- R0255291
- Practice address
- 312 Elm St
Fayetteville, NY 13066-1414 - Phone
- (315) 476-4050
- Fax
- (315) 425-7268
- NPI assigned
- Apr 4, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | R0255291 | NY | Primary |
Addresses
Primary practice location
312 Elm St
Fayetteville, NY 13066-1414
Mailing address
312 Elm St
Fayetteville, NY 13066-1414
Phone (315) 476-4050
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R0255291 | NY | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1175644800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1253750400000",
"number": "1215059159",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "312 ELM ST",
"city": "FAYETTEVILLE",
"state": "NY",
"postal_code": "130661414",
"telephone_number": "315-476-4050",
"fax_number": "315-425-7268"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "312 ELM ST",
"city": "FAYETTEVILLE",
"state": "NY",
"postal_code": "130661414",
"telephone_number": "315-476-4050",
"fax_number": "315-425-7268"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TWICHELL",
"first_name": "TERRY",
"middle_name": "L",
"name_prefix": "Mr.",
"credential": "MSW LCSWR",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-04-04",
"last_updated": "2009-09-24",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NY",
"license": "R0255291",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fayetteville, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 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.