Individual provider Active NPI

Patricia A Hartley-Ferrandino, LCSW

  • Clinical Social Worker
  • Huntington, NY
National Provider Identifier
1235241555
Registry record updated Jun 14, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
075038-R Issued in NY
Practice address
790 Park Ave
Huntington, NY 11743-4516
Phone
(631) 663-4300
Fax
(631) 439-4066
NPI assigned
Aug 31, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 14, 2016

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 075038-R NY Primary

Addresses

Primary practice location

790 Park Ave
Huntington, NY 11743-4516

Mailing address

320 Carleton Ave
Central Islip, NY 11722
Phone (631) 663-4307

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
I20061030000502 NY Practitioner - Clinical Social Worker 0042217358 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
075038-RNYMDClinical Social Worker

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": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1465862400000",
    "number": "1235241555",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "320 CARLETON AVE",
            "city": "CENTRAL ISLIP",
            "state": "NY",
            "postal_code": "11722",
            "telephone_number": "631-663-4307",
            "fax_number": "631-439-4066"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "790 PARK AVE",
            "city": "HUNTINGTON",
            "state": "NY",
            "postal_code": "117434516",
            "telephone_number": "631-663-4300",
            "fax_number": "631-439-4066"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARTLEY-FERRANDINO",
        "first_name": "PATRICIA",
        "middle_name": "A",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-31",
        "last_updated": "2016-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "075038-R",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Huntington, NY

Sources for this page

Verify at the official NPI Registry.