Individual provider Active NPI

Brooke Maureen Lewis, LMSW

  • Social Worker
  • Utica, NY
National Provider Identifier
1306350616
Registry record updated Apr 23, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
102650-1 Issued in NY
Practice address
2606 Genesee St
Utica, NY 13502-6003
Phone
(315) 525-4891
NPI assigned
Nov 22, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 23, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social WorkerGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 104100000X 102650-1 NY Primary

Addresses

Primary practice location

2606 Genesee St
Utica, NY 13502-6003

Mailing address

139 W Bacon St
Waterville, NY 13480-1133
Phone (315) 525-4891

Other names 1

  • Brooke Maureen Mahoney Former name

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
I20220909000740 NY Practitioner - Clinical Social Worker 8820485469 Reassigns benefits to 1 organization
Practice locations: Waterville, NY

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
102650-1NYMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
View Point Clinical Therapy Services, LCSW,PLLC Social Worker CurrentSince Mar 14, 2023 Accepting new patients
DRN Counseling-Consulting Services, LCSW, PLLC Single Specialty PastSince Apr 20, 2022 Accepting new patients

Organizations & group practices 2

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": "1511308800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1524441600000",
    "number": "1306350616",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "139 W BACON ST",
            "city": "WATERVILLE",
            "state": "NY",
            "postal_code": "134801133",
            "telephone_number": "315-525-4891"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2606 GENESEE ST",
            "city": "UTICA",
            "state": "NY",
            "postal_code": "135026003",
            "telephone_number": "315-525-4891"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEWIS",
        "first_name": "BROOKE",
        "middle_name": "MAUREEN",
        "credential": "LMSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-11-22",
        "last_updated": "2018-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Social Worker",
            "state": "NY",
            "license": "102650-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BROOKE",
            "last_name": "MAHONEY",
            "middle_name": "MAUREEN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Utica, NY

Sources for this page

Verify at the official NPI Registry.