Individual provider Active NPI

Kathleen Hamilton

  • Clinical Social Worker
  • Wantagh, NY
National Provider Identifier
1306244579
Registry record updated Apr 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
091110 Issued in NY
Practice address
3375 Park Ave
Wantagh, NY 11793-3733
Phone
(516) 781-1911
Fax
(516) 781-1173
NPI assigned
Dec 19, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2025

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 091110 NY Primary

Addresses

Primary practice location

3375 Park Ave
Wantagh, NY 11793-3733

Mailing address

3375 Park Ave
Wantagh, NY 11793-3733
Phone (516) 781-1911

Other identifiers 1

IdentifierTypeStateIssuer
03003069MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
091110NYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Southeast Nassau Guidance Center Inc. Past Accepting new patients

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": "1418947200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745280000000",
    "number": "1306244579",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3375 PARK AVE",
            "city": "WANTAGH",
            "state": "NY",
            "postal_code": "117933733",
            "telephone_number": "516-781-1911",
            "fax_number": "516-781-1173"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3375 PARK AVE",
            "city": "WANTAGH",
            "state": "NY",
            "postal_code": "117933733",
            "telephone_number": "516-781-1911",
            "fax_number": "516-781-1173"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAMILTON",
        "first_name": "KATHLEEN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-12-19",
        "last_updated": "2025-04-22",
        "certification_date": "2025-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "091110",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03003069",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wantagh, NY

Sources for this page

Verify at the official NPI Registry.