Active NPI
Kerrie-Ann T. Fairclough, LMSW
- Social Worker
- South Hempstead, NY
National Provider Identifier
1316689771
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 101105-01
- Practice address
- 652 Christie St
South Hempstead, NY 11550 - Phone
- (516) 353-1997
- NPI assigned
- Apr 7, 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 |
|---|---|---|---|---|
| Social Worker | 104100000X | 101105-01 | NY | Primary |
Addresses
Primary practice location
652 Christie St
South Hempstead, NY 11550
Mailing address
652 Christie St
South Hempstead, NY 11550
Phone (516) 353-1997
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 |
|---|---|---|---|
| 101105-01 | NY | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1649289600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1649289600000",
"number": "1316689771",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "652 CHRISTIE ST",
"city": "SOUTH HEMPSTEAD",
"state": "NY",
"postal_code": "11550",
"telephone_number": "516-353-1997"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "652 CHRISTIE ST",
"city": "SOUTH HEMPSTEAD",
"state": "NY",
"postal_code": "11550",
"telephone_number": "516-353-1997"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FAIRCLOUGH",
"first_name": "KERRIE-ANN",
"middle_name": "T.",
"credential": "LMSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-04-07",
"last_updated": "2022-04-07",
"certification_date": "2022-04-06",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "NY",
"license": "101105-01",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in South Hempstead, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 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.