Bridgette K Hathaway, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

093976 Issued in NY

Practice address

109 W 27TH St Ste 5S
New York, NY 10001-0265

Phone

(833) 351-8255

NPI assigned

Jul 17, 2020

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• MCCD Psychiatry Services PLLC

  • Psychiatry Physician
  • New York, NY
  • NPI 1033750823
  NPD
• MCCD FL Psychiatry Services PA

  • Psychiatry Physician
  • Jacksonville, FL
  • NPI 1659003457
  NPD
• Children'S Home of Wyoming Conference

  • Voluntary or Charitable Agency
  • Binghamton, NY
  • NPI 1881638658
  NPD (past)

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

{
    "created_epoch": "1594944000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730160000000",
    "number": "1275141061",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 24449",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100870589",
            "telephone_number": "833-351-8255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "109 W 27TH ST STE 5S",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100010265",
            "telephone_number": "833-351-8255"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1182 Chenango St",
            "address_purpose": "LOCATION",
            "city": "Binghamton",
            "state": "NY",
            "postal_code": "139011653",
            "country_code": "US",
            "telephone_number": "607-772-6904 x2228",
            "fax_number": "607-723-2617",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1301 Riverplace Blvd Ste 800",
            "address_purpose": "LOCATION",
            "city": "Jacksonville",
            "state": "FL",
            "postal_code": "322079032",
            "country_code": "US",
            "telephone_number": "833-351-8255",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HATHAWAY",
        "first_name": "BRIDGETTE",
        "middle_name": "K",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-07-17",
        "last_updated": "2024-10-29",
        "certification_date": "2024-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "TPSW3393",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "093976",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02997780",
            "state": "NY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Binghamton",
            "affiliation": "N",
            "endpointDescription": "Practice Location",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1182 Chenango St",
            "city": "Binghamton",
            "state": "NY",
            "country_code": "US",
            "postal_code": "139011653",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Raja Hatem, MD, FRCPC
• Neville Hatfield
• Sarah Hatfield
• Sarah Anne Hatfield
• Mia Hatgis, L.AC.
• Feighanne Hathaway, MS
• Jenna Hathaway
• Maya Grace Hatley
• Wardeh Carlos Hattab, LCSW
• Alyssa Mae Hattem, M.A., CCC-SLP

• Clinical Social Worker in New York, NY
• Providers in New York, NY by specialty
• Clinical Social Worker in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.