Active NPI
Mary Rose Noonan, LMSW
- School Social Worker
- Utica, NY
National Provider Identifier
1306556535
On this page
Key facts
NPPES NPI Registry- Primary specialty
- School Social Worker
- License
- 11831401
- Practice address
- 2630 Remington Rd
Utica, NY 13501-6313 - Phone
- (315) 368-6755
- NPI assigned
- Nov 29, 2022
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| School Social Worker | 1041S0200X | 11831401 | NY | Primary |
Addresses
Primary practice location
2630 Remington Rd
Utica, NY 13501-6313
Mailing address
134 Farmington Rd
Utica, NY 13501-6321
Phone (315) 534-5354
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 11831401 | Medicaid | NY |
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11831401 | NY | MD | School Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1669680000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1671408000000",
"number": "1306556535",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "134 FARMINGTON RD",
"city": "UTICA",
"state": "NY",
"postal_code": "135016321",
"telephone_number": "315-534-5354"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2630 REMINGTON RD",
"city": "UTICA",
"state": "NY",
"postal_code": "135016313",
"telephone_number": "315-368-6755"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NOONAN",
"first_name": "MARY ROSE",
"credential": "LMSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-11-29",
"last_updated": "2022-12-19",
"certification_date": "2022-12-19",
"status": "A"
},
"taxonomies": [
{
"code": "1041S0200X",
"taxonomy_group": "",
"desc": "Social Worker, School",
"state": "NY",
"license": "11831401",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "11831401",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Utica, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.