Individual provider Active NPI

Nina Laurie Faucher, LCSW

  • Clinical Social Worker
  • Clifton Park, NY
National Provider Identifier
1265062632
Registry record updated Jan 24, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
046553 Issued in NY
Practice address
6 Chelsea PL Ste 103
Clifton Park, NY 12065-3236
Phone
(844) 253-4229
Fax
(518) 565-0533
NPI assigned
Jan 24, 2020
Last updated
Jan 24, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 24, 2020

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 046553 NY Primary

Addresses

Primary practice location

6 Chelsea PL Ste 103
Clifton Park, NY 12065-3236

Mailing address

816 S Broadway
Malta, NY 12020-5207
Phone (518) 364-6632

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

LicenseStateTypeSpecialty
046553NYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Mary E Vanalstyne Nurse Practitioner in Family Health PC CurrentSince May 1, 2022 Accepting new patients

Locations

6 Chelsea Pl
Ste 103
Clifton Park, NY 12065
Phone (518) 364-6632

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1579824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1579824000000",
    "number": "1265062632",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "816 S BROADWAY",
            "city": "MALTA",
            "state": "NY",
            "postal_code": "120205207",
            "telephone_number": "518-364-6632",
            "fax_number": "518-565-0533"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6 CHELSEA PL STE 103",
            "city": "CLIFTON PARK",
            "state": "NY",
            "postal_code": "120653236",
            "telephone_number": "844-253-4229",
            "fax_number": "518-565-0533"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAUCHER",
        "first_name": "NINA",
        "middle_name": "LAURIE",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-01-24",
        "last_updated": "2020-01-24",
        "certification_date": "2020-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "046553",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clifton Park, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2020; 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.