Individual provider Active NPI

Renea Braley, LMSW

  • Social Worker
  • Liverpool, NY
National Provider Identifier
1235017070
Registry record updated Aug 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
118157-01 Issued in NY
Practice address
4203 Halfmoon Cir
Liverpool, NY 13090-6836
Phone
(315) 573-5305
NPI assigned
Aug 21, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 21, 2025

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 118157-01 NY Primary

Addresses

Primary practice location

4203 Halfmoon Cir
Liverpool, NY 13090-6836

Mailing address

4203 Halfmoon Cir
Liverpool, NY 13090-6836
Phone (315) 573-5305

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
118157-01NYMDSocial Worker

NPI Registry JSON

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

{
    "created_epoch": "1755734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755734400000",
    "number": "1235017070",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4203 HALFMOON CIR",
            "city": "LIVERPOOL",
            "state": "NY",
            "postal_code": "130906836",
            "telephone_number": "315-573-5305"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4203 HALFMOON CIR",
            "city": "LIVERPOOL",
            "state": "NY",
            "postal_code": "130906836",
            "telephone_number": "315-573-5305"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRALEY",
        "first_name": "RENEA",
        "name_prefix": "Mrs.",
        "credential": "LMSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-08-21",
        "last_updated": "2025-08-21",
        "certification_date": "2025-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "118157-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Liverpool, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2025; 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.