Individual provider Active NPI

Stefani Holden

  • Social Worker
  • Staten Island, NY
National Provider Identifier
1306212600
Registry record updated Dec 29, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
Practice address
76 Pitney Ave
Staten Island, NY 10309-1919
Phone
(347) 866-8199
NPI assigned
Aug 20, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 29, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X NY
Student in an Organized Health Care Education/Training Program 390200000X 386470710 NY
Social Worker 104100000X Primary

Addresses

Primary practice location

76 Pitney Ave
Staten Island, NY 10309-1919

Mailing address

76 Pitney Ave
Staten Island, NY 10309-1919
Phone (929) 420-8237

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
I20240605002149 NY Practitioner - Clinical Social Worker 1658813621 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
National Neighborhood Counseling Center IncGroup PAC ID 1052202157, 13 clinicians

Practice addresses (Care Compare)

7701 13TH Ave
Brooklyn, NY 11228-2413
Phone (718) 232-1351

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
386470710NYMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
National Neighborhood Counseling Center Inc CurrentSince Apr 21, 2024 Accepting new patients

Locations

7701 13th Ave
Brooklyn, NY 11228
Phone (718) 232-1351

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": "1440028800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609200000000",
    "number": "1306212600",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "76 PITNEY AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103091919",
            "telephone_number": "929-420-8237"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "76 PITNEY AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103091919",
            "telephone_number": "347-866-8199"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLDEN",
        "first_name": "STEFANI",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-08-20",
        "last_updated": "2020-12-29",
        "certification_date": "2020-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": null,
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NY",
            "license": "386470710",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Staten Island, NY

Sources for this page

Verify at the official NPI Registry.